LecturePatient will present as → a 37-year-old male with crusting, scaling, red-rimming of the eyelid, and eyelash flaking along with dry eyes. The patient has a history of seborrheic dermatitis and rosacea.
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Chronic inflammation of the eyelids without mass and without significant pain, caused by a dysfunctional meibomian gland or staph infection
- Associated with seborrhea and rosacea
- Crusty eyelids in the AM
Blepharitis: notice the inflamed, flakey eyelid
Blepharitis is a clinical diagnosis based on characteristic findings of redness and irritation of the eyelid margin associated with crusting or flakes on the lashes or lid margins
- Slit-lamp examination allows for a more detailed examination; however, is generally not necessary to make the diagnosis.
- Chronic blepharitis that does not respond to treatment may require a biopsy to exclude eyelid tumors that can simulate the condition
Treat with warm compresses, irrigation, lid massage, and topical antibiotics for flare-ups
- Daily lid wash with baby shampoo
Question 1 |
Antibiotic ointment (eg, bacitracin/polymyxin B, erythromycin, or gentamicin 0.3% qid for 7 to 10 days) | |
Warm compresses over the closed eyelid | |
Tear supplements during the day | |
Gentle cleansing of the eyelid margin 2 times a day with a cotton swab dipped in a dilute solution of baby shampoo (2 to 3 drops in ½ cup of warm water) | |
all of the above |
Question 2 |
Autoimmune destruction of meibomian glands Hint: Autoimmune destruction of meibomian glands is more indicative of conditions like meibomian gland dysfunction, not anterior blepharitis. | |
Infection of the eyelid margin by Staphylococcus species | |
Allergic reaction to environmental antigens Hint: Allergic reactions can cause eyelid inflammation but are not the primary mechanism of blepharitis. | |
Blockage of the lacrimal drainage system Hint: Blockage of the lacrimal drainage system leads to conditions like dacryocystitis, not blepharitis. | |
Degenerative changes in the tarsal plate Hint: Degenerative changes in the tarsal plate are not associated with blepharitis. |
Question 3 |
Eyelid erythema and scaling at the lash base | |
Painless, firm nodule on the eyelid Hint: A painless, firm nodule on the eyelid is more indicative of a chalazion. | |
Outward turning of the eyelid margin Hint: Outward turning of the eyelid margin describes ectropion, not blepharitis. | |
Inward turning of the eyelid margin Hint: Inward turning of the eyelid margin is characteristic of entropion, not blepharitis. | |
Acute, localized swelling of the eyelid Hint: Acute, localized swelling of the eyelid is suggestive of a hordeolum (stye), not blepharitis. |
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References: Merck Manual · UpToDate