Blepharitis: Red Eye (Diagnose & Treat)

Question 1

What is blepharitis?

Answer 1

Inflammation of the eyelid margins

Question 2

What is the epidemiology?

Answer 2

Very common

Question 3

What are the signs and symptoms of blepharitis?

Answer 3

Bilateral (all 4 eyelids)
Gritty, burning, irritable eyes.
Eyes may be sticky in the morning.
Eyelid margins may be red and swollen.
Mild conjunctival redness.
Styes and chalazions are more common.
Secondary conjunctivitis may occur.

Loss of eyelashes, ingrowing eyelashes, chalazia and styes (lid lumps) more common.

Question 4

What are the types?

Answer 4

Chronic, intermittent, variable

Question 5

What is the function of the meibomian glands?

Answer 5

Secrete oil onto the eye surface to prevent rapid evaporation of the tear film
(Hence why blepharitis can cause dry eyes and irritation)

Question 6

What condition is associated with Blepharitis?

Answer 6

Rosacea

Question 7

Management?

Answer 7

Not curable

Hot compresses twice daily
Lid hygiene - removal or debris from lid margins
Chloramphenicol ointment to base of eyelashes
Tear substitutes
Treat rosacea

Question 8

How does it look?

What history would distinguish this?

Answer 8

Bilateral, inflammed eyelids

May be accompanied by conjunctivitis

Question 9

What are the causes of blepharitis?

Answer 9

Meibomian gland dysfunction (common, posterior blepharitis)

Seborrhoeic dermatitis/staphylococcal infection (less common, anterior blepharitis)