Blepharitis

Blepharitis

  • is an ocular condition characterized by chronic inflammation of {the} eyelid, {the} severity and time course of which can vary. It can onset acutely resolving without treatment within 2–4 weeks (this can be greatly reduced with lid hygiene) but more generally is a long standing inflammation varying in severity.

Signs and symptoms

Signs and symptoms that are associated with {the} chronic inflammation can be;

  • Redness of {the} eyelids.
  • Flaking of skin on {the} lids.
  • Crusting at {the} lid margins, this is generally worst on waking.
  • Cysts at {the} lid margin (hordeolum).
  • Red eye.
  • Debris in {the} tear film, seen under magnification (improved contrast with use of fluorescein drops).
  • Gritty sensation of {the} eye.
  • Reduced vision.

 

 

Common signs and symptoms of blepharitis also include itching, irritation and burning as well as a foreign body sensation. Some patients experience eye dryness, which can cause a certain degree of discomfort.

Blepharitis that localizes in {the} skin of {the} eyelids could cause styes or chalazia, which appear like red bumps, frequently with a yellow spot if infection is present. Although pain is not common among blepharitis symptoms, if {the} condition persists or becomes painful, {the} individual is recommended to seek medical attention.

Chronic blepharitis could result in damage of varying severity which could have a negative effect upon vision and therefore upon {the} eyeglass prescription.

Infectious blepharitis can cause hard crusts around {the} eyelashes which leave small ulcers that could bleed or ooze after cleaning.

As a general rule, blepharitis whose symptoms do not improve despite good hygiene consisting of proper cleaning and care of {the} eye area, should be referred to a doctor.

Staphylococcal blepharitis

Staphlycoccal blepharitis is caused by infection of {the} anterior portion of {the} eyelid by Staphylococcal bacteria. As {the} infection progresses, {the} sufferer could begin to notice a foreign body sensation, matting of {the} lashes, and burning. Usually, {the} primary care physician will prescribe topical antibiotics for staphylococcal blepharitis, as this is an acute condition and should heal quickly. The condition can frequently lead to a chalazion or a stye.

Staphylococcal blepharitis is a more severe condition which could start in childhood and continue through adulthood.  It is commonly recurrent and it requires special medical care. The prevalence of Staphylococcus aureus in {the} conjunctival sac and on {the} lid margin varies among countries, apparently according to climate. 

In cases of blepharitis caused by Staphylococcus aureus, {the} presence of a collarette (a ring-like formation around {the} lash shaft) can be observed. This is {the} main sign of this particular condition. Other specific symptoms include loss of eyelashes or broken eyelashes.

Staphylococcal blepharitis is mainly diagnosed upon {the} patient's medical history and a bacterial culture. However, since blepharitis is a condition that is completely understood, diagnosis usually consists of establishing an accurate medical history of {the} patient and a proper physical examination. Blepharitis is diagnosed primarily upon physical examination and rarely further tests are needed. Yet, it is recommended that older patients or those who are at risk of developing certain skin conditions undergo biopsy in order to remove {the} possibility of tumor.

This type of blepharitis is more likely to occur in individuals who are exposed to bacteria. Staphylococcal blepharitis, unlike {the} other types of this condition, seems to be seen more commonly in women than in men.

It is important that this type of blepharitis is suitably treated because otherwise {the} infection could spread to other parts of {the} eye or to {the} scarring of {the} cornea. Staphylococcal blepharitis is normally treated with antibiotics such as Chloramphenicol ointment. Fusidic acid is usually {the} choice of antibiotics in cases when Chloramphenicol is contraindicated. Antibiotics are given for at least four weeks and up to six weeks, which is considered enough so {the} infection is completely cured. Also, blepharitis treatment includes a short cure of topical steroids which are administered to control {the} inflammation.

Staphylococcal blepharitis, along with {the} other types of blepharitis treatment is only effective if given at {the} same time with extra cautious eyelid hygiene. This consists of eyelid proper cleaning and removing crusts and debris and maintaining {the} hygiene by avoiding expired make up or cosmetics that are used around {the} eye. Particularly in blepharitis caused by S. aureus, patients are recommended to keep {the} eyelids area clean to avoid spreading {the} infection when oozing and bleeding occurs.

Posterior blepharitis or rosacea-associated blepharitis

"Internal hordeolum"

The most common type of blepharitis is often found in people with a Rosacea skin type. The oil glands in {the} lid of rosacea sufferers secrete a modified oil which leads to inflammation at {the} meibomian gland openings which are found at {the} edge of {the} lid

 

 

 

 

Procedures
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