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General Medicine

Blepharitis

Sydney Dittman, MD and Nida S. Awadallah, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Common, usually chronic, inflammatory reaction of the eyelid margin

  • Commonly presents as irritation, burning, redness, flaking, crusting of the eyelids worse in morning, contact lens ...

DIAGNOSIS

HISTORY

  • Duration of symptoms

  • Unilateral or bilateral presentation

  • Note any exacerbating conditions (e.g., smoke, allergens, wind, contact lenses).

  • Pertinent past medical history: rosacea, herpet...

TREATMENT

GENERAL MEASURES

  • Promote proper eyelid hygiene (1),(2)[C].

    • Apply warm compresses for several minutes at least once a day to soften adherent encrustations.

    • The eyelid margins then are scrubbed...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Patients should schedule a return visit if their condition worsens despite treatment.

  • Return visit intervals for patients with severe disease var...

REFERENCES

1
American Academy of Ophthalmology Cornea/External Disease Panel. Preferred Practice Pattern Guidelines: Blepharitis. San Francisco, CA: American Academy of Ophthalmology; 2013. [View Abstr...

ADDITIONAL READING

American Academy of Ophthalmology. Blepharitis Summary Benchmarks for Preferred Practice Pattern Guidelines. San Francisco, CA: American Academy of Ophthalmology; 2015. [View Abst...

SEE ALSO

Lacrimal Disorders (Dry Eye Syndrome) 

CODES

ICD10

  • H01.009 Unspecified blepharitis unspecified eye, unspecified eyelid

  • H01.019 Ulcerative blepharitis unspecified eye, unspecified eyelid

  • L21.8 Other seborrheic dermatitis

  • H01.029 Squamous blepha...

CLINICAL PEARLS

  • Blepharitis is often a chronic condition; symptoms frequently can be lessened but rarely are eliminated.

  • Promote proper eyelid hygiene.

  • Maxitrol ointment can be used for short-term contr...

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1.3. A: Blepharitis is associated with crusting of the eyelashes, thickening of the eyelids, telangiectatic vessels along the lid margins, and plugging of the meibomian glands.
1.3. A: Blepharitis is associated with crusting of the eyelashes, thickening of the eyelids, telangiectatic vessels along the lid margins, ...
1.4. Blepharitis may be associated with rosacea that is manifested by telangiectatic vessels on the skin and, as in the advanced case shown here, with rhinophyma.
1.4. Blepharitis may be associated with rosacea that is manifested by telangiectatic vessels on the skin and, as in the advanced case shown...
1.7. In atopic blepharitis, there is an eczematoid reaction of the eyelids.
1.7. In atopic blepharitis, there is an eczematoid reaction of the eyelids.
1.11.C: In severe adenoviral conjunctivitis, the patient may have lid ecchymoses in addition to subconjunctival hemorrhages.
1.11.C: In severe adenoviral conjunctivitis, the patient may have lid ecchymoses in addition to subconjunctival hemorrhages.
1.12. D: Giant papillary conjunctivitis is characterized by papillae of the superior tarsus, which are thought to be caused by an allergic reaction to the coating on foreign bodies such as contact lenses or exposed sutures.
1.12. D: Giant papillary conjunctivitis is characterized by papillae of the superior tarsus, which are thought to be caused by an allergic ...
1.14. Acute bacterial conjunctivitis with mild lid swelling, conjunctival injection, and discharge along the lid margin.
1.14. Acute bacterial conjunctivitis with mild lid swelling, conjunctival injection, and discharge along the lid margin.
1.11. A: Viral conjunctivitis is associated with an acute follicular reaction. In follicles, vessels course on the surface from the periphery of the lesions toward the center rather than emerging in the center, as is the case in papillae.
1.11. A: Viral conjunctivitis is associated with an acute follicular reaction. In follicles, vessels course on the surface from the periphe...
FIG. 2.6. A: Conjunctivitis. B: Chemosis. C: Facial swelling caused by an allergic reaction.
FIG. 2.6. A: Conjunctivitis. B: Chemosis. C: Facial swelling caused by an allergic reaction.
Blepharitis.
Blepharitis.
FIG. 15.10. Allergic conjunctivitis with lid edema and conjunctival infection.
FIG. 15.10. Allergic conjunctivitis with lid edema and conjunctival infection.
FIG. 15.11. Allergic conjunctivitis with chemosis. Note the swollen conjunctiva extending up to the border of the cornea.
FIG. 15.11. Allergic conjunctivitis with chemosis. Note the swollen conjunctiva extending up to the border of the cornea.
1.6. Seborrheic blepharitis is associated with crusting of the eyelids without meibomian gland inflammation and with seborrheic dermatitis of the eyebrows and scalp.
1.6. Seborrheic blepharitis is associated with crusting of the eyelids without meibomian gland inflammation and with seborrheic dermatitis ...
1.15. A: Hyperacute gonococcal conjunctivitis, with copious mucopurulent discharge and lid swelling.
1.15. A: Hyperacute gonococcal conjunctivitis, with copious mucopurulent discharge and lid swelling.
Seborrheic blepharitis
Seborrheic blepharitis
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