Blepharitis: Difference between revisions
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==Background== | ==Background== | ||
[[File:eyelid glands.png|thumb|Eyelid crossectional anatomy]] | [[File:eyelid glands.png|thumb|Eyelid crossectional anatomy]] | ||
[[File:Tear system.png|thumb|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]] | [[File:Tear system.png|thumb|Right eye lacrimal system consisting of: of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d).]] | ||
Latest revision as of 21:43, 4 February 2026
Background
- Inflammation of eyelids
- Acute (ulcerative or nonulcerative)
- Chronic (meibomian gland dysfunction, seborrheic blepharitis)
Clinical Features
- Sore/itchy
- Inflammation of lid margin with ocular irritation, matted lashes
- Blurry vision
- Tearing
- Crusting at the lid margins
- Distinguish anterior from posterior blepharitis using slit lamp
- Posterior - swelling and plugging of meibomian gland openings
- Anterior - on external exam, material such as greasy flakes (seborrheic) or hard crust (staph) surrounds eyelashes
Differential Diagnosis
Periorbital swelling
Proptosis
- Normal IOP
- Orbital cellulitis
- Orbital pseudotumor
- Orbital tumor
- Increased IOP
- Retrobulbar abscess
- Retrobulbar emphysema
- Retrobulbar hemorrhage
- Ocular compartment syndrome
- Orbital tumor
No proptosis
- Periorbital cellulitis/erysipelas
- Dacryocystitis (lacrimal duct)
- Dacryocele/Dacryocystocele
- Dacryostenosis
- Dacryoadenitis (lacrimal gland)
- Allergic reaction
- Nephrotic Syndrome (pediatrics)
Lid Complications
- Blepharitis (crusts)
- Chalazion (meibomian gland)
- Stye (hordeolum) (eyelash folicle)
Other
- Subperiosteal abscess
- Orbital abscess
- Cavernous sinus thrombosis
- Conjunctivitis
- Contact dermatitis
- Herpes zoster
- Herpes simplex
- Sarcoidosis
- Granulomatosis with polyangiitis
Evaluation
- Clinical diagnosis
Management
- Lid hygiene most important for both anterior and posterior blepharitis
- Avoid eye-makeup
- Warm compresses 15min 4x/day
- Scrub with mild shampoo BID
- Consider topical erythromycin or bacitracin directly onto lid margin
- No conclusive evidence for oral antibiotics or topical steroids
Disposition
- Outpatient optho - chronic condition without definitive cure