Lid hygiene, consisting of lid cleansing using a variety of measures, is the first line of management regardless of type of blepharitis. Patients should be made aware of the importance of the chronic nature of the condition and the need of on-going treatment. Management of Dry Eye Disease, if also present: see Clinical Management Guideline on Dry Eye Disease. secondary signs include: punctate epithelial erosion over lower third of cornea marginal keratitis scarring neovascularisation and pannus mild papillary conjunctivitis.evaporative tear deficiency, unstable pre-corneal tear film.plugging of duct orifices with abnormal lipid leading to dilatation of glands and formation of microliths and chalazia.foam in the lower tear film meniscus (due to excess tear film lipid).thick and/or opaque secretion at meibomian gland orifices, making it difficult or impossible to express oil by finger pressure.Posterior blepharitis (MGD is the most common cause) persistent infestation of the lash follicles may lead to misalignment, trichiasis or madarosis.'cylindrical dandruff’: characteristic clear sleeve (collarette) covers base of lash, extending further up lash than flat staphylococcal rosettes.secondary signs include: punctate epithelial erosion over lower third of cornea marginal keratitis phlyctenulosis neovascularisation and pannus mild papillary conjunctivitis.crusting of anterior lid margin (scales at bases of lashes).Signs of blepharitis (lid margin disease) Posterior blepharitis is a leading cause of evaporative dry eye.Ī significant association has been found between Demodex infestation and blepharitis (see evidence base), though the role of the mite in the pathogenesis of the condition is unclear. 25-40% of people with seborrhoeic blepharitis.50% of people with staphylococcal blepharitis.elements of both conditions are present.Īll of these conditions are typically bilateral, and chronic or relapsing.meibomian secretion becomes abnormal both chemically and physically.bacterial lipases break down meibomian lipids.Posterior blepharitis (also known as Posterior Lid Margin Disease) seborrhoeic (disorder of the ciliary sebaceous glands of Zeis).caused by (1) direct infection, (2) reaction to staphylococcal exotoxin or (3) allergic response to staphylococcal antigen.Blepharitis is conventionally classified as:Īnterior blepharitis (also known as Anterior Lid Margin Disease) Blepharitis is a chronic inflammation of the eyelids that primarily affects the eyelid margins and is one of the most common presentations in primary eye care.
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