Blepharitis

Question 1

Pathophysiology?

Answer 1

Inflammation of the eyelid margins due to either meibomian gland dysfunction (common, posterior blepharitis) or seborrhoeic dermatitis/staphylococcal infection (less common, anterior blepharitis).

Question 2

How does meibomian gland dysfunction cause blepharitis?

Answer 2

The meibomian glands secrete oil on to the eye surface to prevent rapid evaporation of the tear film. Any problem affecting the meibomian glands (as in blepharitis) can hence cause drying of the eyes which in turns leads to irritation

Question 3

Blepharitis is more common in which patients?

Answer 3

Patients with roasacea

Question 4

Symptoms?

Answer 4

• symptoms are usually bilateral
• grittiness and discomfort, particularly around the eyelid margins
• eyes may be sticky in the morning
• eyelid margins may be red. Swollen eyelids may be seen in staphylococcal blepharitis
• styes and chalazions are more common in patients with blepharitis
• secondary conjunctivitis may occur

Question 5

Management?

Answer 5

• softening of the lid margin using hot compresses twice a day
• ‘lid hygiene’ - mechanical removal of the debris from lid margins
• – cotton wool buds dipped in a mixture of cooled boiled water and baby shampoo is often used
• – an alternative is sodium bicarbonate, a teaspoonful in a cup of cooled water that has recently been boiled
• artificial tears may be given for symptom relief in people with dry eyes or an abnormal tear film