INESSS Blepharitis

Question 1

Risk factors for Blepharitis (3)

Answer 1

1- Rosacea
2- Seborrheic dermatitis
3- Atopic dermatitis

Question 2

History for blepharitis (3)
3rd has 9.

Answer 2

1- eye/skin problems
2- eye surgery
3- Symptoms (eyelids stuck together AM, eye discomfort, burning sensation, tearing, pruritus, foreign body sensation, intolerance to contact lenses, temporarily blurred vision)

Question 3

Physical exam for blepharitis (4)

Answer 3

1- Signs of eyelid (redness, swelling, thickening eyelid, crust, inflammation, nordule or bump
2- Signs in both eyes, specially conjunctiva and cornea (redness)
3- Other skin lesions associated with risk factors
4- Absence of herpetic veiscles

Question 4

Red flags blepharitis (5)

Answer 4

1- Photophobia
2- Loss of vision or visual acuity
3- Severe pain in eye or eyelid
4- Severe redness with diffuse conjunctival hyperemia
5- Keratitis with fluorescein uptake

Question 5

Ddx for blepharitis (8)

Answer 5

1- Conjunctivitis
2- Contact dermatitis
3- Dacryocystitis
4- Drug induced dermatitis caused by use of ophthalmic drugs
5- Herpes simplex eye disease
6- Herpes Zoster ophthalmimcus
7- Infectious periorbital cellulitis
8- Seasonal allergies
9- Sebaceous gland carcinoma

Question 6

1st line treatment for Blapharitis

Answer 6

1- Warm compresses 5-10 minutes 2-4x daily
2- Hygiene, clean eyeslids with ophthalmic wipe or mild/diluted soap
3- Massage (mostly for chronic blepharitis)
4- Local hydration/artificial tears

Question 7

Hygiene and compresses for Blepharitis, how long do we do this for:
1- Hordeolum,/stye
2- Chalazion

Answer 7

1- 3-4 days until symptoms disappear
2- Several weeks to months until disappears.

Question 8

When do you use topical antibiotics (2nd line treatment) in blepharitis?

Answer 8

When non pharmacological measures have been used optimally and failed.

Question 9

2nd line tx for blepharitis?

Answer 9

Erythromycin ointment, 0.5%. One strip in the affected eye DIE HS x 4 weeks.

Question 10

Can NP start 3rd line tx for blepharitis? And what is it.

Answer 10

Needs slit lamp examination first. Topical corticosteroid.