Blepharitis – chronic and posterior

Question 1

Background for all types

Answer 1

Blepharitis is a common chronic inflammatory condition affecting the margin of the eyelids.
TYPES: (ALL chronic)

Anterior -inflammation of the base of the eyelashes (located on the anterior margin of the eyelid

Posterior - inflammation of the meibomian glands (often called meibomian gland dysfunction).
Can get mixed.

Question 2

Signs and symptoms / Diagnosis

Answer 2

Signs and symptoms:
- Burning, itching and/or crusting of the eyelids.
- Symptoms worse in the mornings.
- Both eyes are affected.
- Recurrent hordeolum (small lump)
- Contact lens intolerance.
Extra for Chronic:
- thickened eye lids
- Lead to a loss of eye lashes.

Diagnosis:
Examination, history taking
Severe cases can do swab and refer for biopsy.

Question 3

Treatment

Answer 3

Appropriate lid hygiene;
- eyelid margins must be scrubbed with a baby shampoo or similar product BD,
- Warm compresses applied to alleviate the symptoms.

If hygiene fails:

Anterior = Topical
Posterior = systemic
Antibiotic topical or systemic (doxycycline or tetracycline[not for P,BF,<12yrs)
Treatment is ongoing as condition is rarely completely eradicated. Frequent use of artificial tears helps with dry eyes.