blepharitis
BLEPHARITIS
Blepharitis is an inflammation process affecting the eyelid margins, eyelash follicles or openings of the anteriorly-placed accessory lacrimal glands and the posteriorly-placed Meibomian glands that causes ocular irritation and redness acutely but usually chronically.
It may have periods of exacerbations and remissions.
It usually occurs in middle-aged adults but can also start in childhood.
Can affect vision by disrupting the surface of the cornea and the bulbar conjunctiva; may influence tear film composition.

Introduction

  • Blepharitis may have periods of exacerbations & remissions
  • Usually occurs in middle-aged adults but can also start in childhood
  • Can affect vision by disrupting the surface of the cornea & the bulbar conjunctiva; may influence tear film composition

Definition

  • An inflammatory process affecting the eyelid margins, eyelash follicles, or openings of the anteriorly-placed accessory lacrimal glands & the posteriorly-placed Meibomian glands that causes ocular irritation & redness acutely but usually chronically

Risk Factors

Associated Conditions

  • Ocular conditions
    • Keratoconjunctivitis sicca may cause alteration in bacteria resistance brought about by the decrease in local lysozyme & immunoglobulin levels
    • Hordeolum/Stye is an acute infection of the oil gland of the eyelid that causes abnormal secretions that block the glands which may secondarily infected
    • Chalazion is a firm non-tender bump in the eyelid caused by granulomatous inflammatory reaction of the Meibomian gland
    • Dry eye may result from abnormal or decreased meibomian gland secretions
    • Contact lens intolerance or discomfort due to alteration in the lipid layer of the tear film 
  • Dermatological diseases
    • Rosacea is associated w/ epithelial basement membrane abnormalities & recurrent corneal epithelial erosions
    • Seborrheic dermatitis has been found in most patients w/ seborrheic blepharitis
  • Demodex folliculorum
    • Recalcitrant blepharitis has responded to treatment directed at Demodex mites eradication 
  • Isotretinoin
    • Oral medication for severe cystic acne
    • Causes an increase colonization of the conjunctiva w/ Staphylococcus aureus & disruption in tear function predisposing to the development of staphylococcal blepharitis
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