Eye OTC - Blepharitis

Question 1

What are the types of eyelid disorders? (3)

Answer 1

Stye ( 1 eye): self-limiting within 2-3 days.
Blepharitis (both eyes): eyelid inflammation
Meibomian cyst: Hard, painless lumb under eyelid. Resolves spontaneously.

Question 2

Define Blepharitis. (3)

Answer 2

Eyelid inflammation:
- Bilateral effect
- Lashes base (anterior)
- Meibomian glands (posterior)

Question 3

What are the types of blepharitis? (3)

Answer 3

Staphylococcal: Affects the anterior eyelids, lash crusting, lid ulceration and foliculitis.

Seborrhoic: Anterior eyelids. Caused by excessive sebum. Associated with seborrhoeic dermatitis.

Meibomian gland dysfunction: Posterior eyelid margin. Associated with seborhoeic dermatitis +/or rosacea.

Question 4

What are the symptoms of Blepharitis? (5)

Answer 4

Intermittent, Bilateral
Sore eyelids = common symptoms
Gritty eyes
Dry eyes: Blurred vision, contact lenses intolerance.
Eyelids sticking together (common in the morning).

Question 5

What are the signs of Blepharitis? (5)

Answer 5

Swollen eyelids (staphylococcal Blepharitis + meibomitis)
Inflamed lid margins
Altered eyelash appearances: misdirection, crusting + eyelash loss.
Eyelid surfaces (scaly,oily or greasy)
Stye
Inflamed conjunctiva (common complication)

Question 6

What counselling points should be given to patients with Blepharitis? (5)

Answer 6

Lid hygiene
Compliance with tx.
Contact lenses not worn.

Topical chloramphenicol or fusidic acid.
Refer to GP:
- Rosacea (Meibomian gland dysfunction)
- Seborrhoeic dermatitis )Seborrhoeic blepharitis)
- Atopic Eczema (staphylococcal Blepharitis)

Question 7

Counsel a patient on lid hygiene. (3)

Answer 7

Eyelid cleansing done BD initially. Once symptoms have improved, reduced to OD.

Daily cleansing continued indefinitely to reduce reoccurrence.

Eye make up esp. eyeliner (contributing factor). Avoid use of eyeliner or use eyeliner that washes off easily.

Question 8

Explain to the patient on how to cleanse the eyelids. (3)

Answer 8

1 teaspoon in a cup of boiled water (sodium bicarbonate)

Diluted baby shampoo with warm water is applied with a clean cloth rubbed along the eyelids.

Boiled/perserved water (for contact lenses wearers) = effective as sodium bicarbonate or diluted baby shampoo.