Blepharitis

Blepharitis

OVERVIEW:

Blepharitis is an inflammation of the edge of the eyelid. It occurs as an ulcerous form or nonulcerous form. It commonly occurs as a combination of both forms.

SIGNS AND SYMPTOMS:

• Ulcerous (staph) blepharitis
• Itching
• Excessive tearing
• Burning sensation
• Light sensitivity
• Usually worse in morning
• Recurring stye
• Ulcerations at the base of eyelashes
• Broken, sparse, misdirected eyelashes
• Nonulcerous (seborrheic) blepharitis
• Reddening at the edge of the eyelid
• Dry flakes, oily skin on lid edge and/or lashes
• Dandruff of scalp, eyebrows
• Sometimes reddening or flaking of skin on the nose and lips
• Mixed blepharitis (seborrheic with associated staph)
• Most common type of blepharitis
• Symptoms and signs of both staph and seborrheic present

CAUSES:

• Sebaceous gland dysfunction
• Bacterial (Staphylococcus) infection
• Dermatitis

SCOPE:

Common; blepharitis is the most common eye disease in the United States.

MOST OFTEN AFFECTED:

Adults, males and females in equal proportion

RISK FACTORS:

• Infection
• Dermatitis
• Rosacea
• Diabetes mellitus
• Immune system disorders

DIAGNOSIS

PHYSICAL EXAMINATION:

The Physician will assess the eye and consider other similar conditions.

TESTS AND PROCEDURES:

• Blood tests may be done to assist in diagnosis.
• Fluid or cells from the affected area may be analyzed in the laboratory.

TREATMENT

GENERAL MEASURES:

• Blepharitis is managed in an outpatient setting.
• Wash affected area with cleanser at least once daily.
• If infection is suspected, topical antibiotic should be applied with cotton-tipped swab.
• Clean lids and apply ointment nightly in mild cases, up to 4 times daily in severe cases.
• Discontinue soft contact lenses until condition clears.
• Chronic blepharitis requires referral to ophthalmologist for evaluation.

ACTIVITY:

No restrictions

DIET:

No restrictions

MEDICATIONS

COMMONLY PRESCRIBED DRUGS:

• Topical antibiotic: bacitracin, erythromycin ointment
• In some cases, oral antibiotics: tetracycline

CONTRAINDICATIONS:

• Allergy to medication
• Tetracycline: not for use in pregnancy or children younger than 8 years of age

PRECAUTIONS:

• Avoid medication containing neomycin as it is sensitizing.
• Tetracycline may cause photosensitivity; sunscreen is recommended.

DRUG INTERACTIONS:

• Tetracycline: avoid antacids, dairy products, and iron
• Antibiotics may reduce the effectiveness of oral contraceptives.

Other Drugs:

Quinolones may be helpful for persistent or recurrent blepharitis.

FOLLOW UP

PATIENT MONITORING:

The Physician should be seen every 2 months.

PREVENTION/AVOIDANCE:

Follow treatment guidelines.

COMPLICATIONS: