MDT Eye Blepharitis

Question 1

The _______ describes the portion located at the edge of the eyelid. It is the juncture of the conjunctiva and the skin, known as the mucocutaneous margin. It is the site of the eyelashes as well as the orifice (opening) of the ______ glands.

Answer 1

Eyelid margin
Meibomian

Question 2

What is a common chronic bilateral inflammatory condition of the lid margins

Answer 2

Blepharitis

Question 3

Anterior blepharitis involves what structures of the eye?

Answer 3

the lid skin, eyelashes, and associated glands

Question 4

Posterior blepharitis results from inflammation of what glands?

Answer 4

Meibomian Glands

Question 5

what may be ulcerative, because of infection by staphylococci, or seborrheic in association with seborrhea of the scalp, brows, and ears

Answer 5

Anterior blepharitis

Question 6

What may be bacterial infection, particularly with staphylococci, or primary glandular dysfunction, in which there is a strong association with acne rosacea?

Answer 6

Posterior blepharitis

Question 7

What is the common bacteria that causes Blepharitis?

Answer 7

Staphylococci

Question 8

From your PE what would you expect?
S/s Itching, burning, mild pain, foreign body sensation, tearing, erythema of the lids, and crusting around the eyes upon awakening.

-eyes are “redrimmed” and scales or granulations can be seen clinging to the lashes.

-The lid margin is frequently rolled inward (mild entropion).
-Pink or irritated eyelids, which may have crusting.
May have conjunctival injection.
-Tears may be frothy or abnormally greasy.

Answer 8

Anterior blepharitis

Question 9

From your PE what would you expect?
S/s Itching, burning, mild pain, foreign body sensation, tearing, erythema of the lids, and crusting around the eyes upon awakening.

-margins are hyperemic with telangiectasia, and the Meibomian glands and their orifices are inflamed.

-The lid margin is frequently rolled inward (mild entropion).
-Pink or irritated eyelids, which may have crusting.
May have conjunctival injection.
-Tears may be frothy or abnormally greasy

Answer 9

Posterior blepharitis

Question 10

What are some ddx for Blepharitis?

Answer 10

(1) Conjunctivitis
(2) Pediculosis
(3) Rosacea

Question 11

Tx for Blepharitis
Scrub the eyelid margins twice a day with a commercial eyelid scrub (Ocusoft) or _____ on a washcloth

Answer 11

baby shampoo

Question 12

Tx for Blepharitis
True/False
You can have your pt apply a warm compresses for 10 to 15 minutes 1-2x/day.

Answer 12

True

Question 13

Tx for Blepharitis
What is the antistaphylococcal antibiotic eye ointment applied to the lid margins

Answer 13

Bacitracin ointment
Apply one application twice daily (BID)

Question 14

Tx for Blepharitis
What can you use for Long-term, low-dose oral antibiotic therapy

Answer 14

Tetracycline 250mg BID
Doxycycline 100mg BID for 7 days
Erythromycin 250 mg PO QID
Azithromycin (Zpack)

Question 15

What is the most effective antibiotic with the fewest effects?

Answer 15

a Tetracycline

Question 16

What are some complications of blepharitis?

Answer 16

(1) Permanent alterations in the eyelid margin.
(2) Vision loss (from superficial keratopathy).
(3) Corneal neovascularization and ulceration.

Question 17

Initial Care of the Disease and Follow Up
Blepharitis

Answer 17

(1) Follow up 2 to 4 weeks depending on severity of presenting symptoms.
(2) Eyelid scrubs and warm compresses may be reduced to once daily as the
condition improves, but may need to be maintained indefinitely.