Blepharitis

Published on 10/06/2015 by admin

Filed under Pediatrics

Last modified 22/04/2025

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Blepharitis

Anna F. Fakadej, MD, FAAO, FACS

Basic Information

Definition

Blepharitis is a spectrum of acute and chronic inflammation of the eyelids.

Synonyms

Chalazia
Meibomitis
Seborrheic blepharitis
Staphylococcus blepharitis

ICD-9-CM Code

373.00 Blepharitis—unspecified

Epidemiology & Demographics

More commonly a disease of adults but can be seen in pediatric population.

Clinical Presentation

History

• Nonspecific ocular discomfort (burning, irritation, and itching)
• Red eye
• Tearing
• Ocular discharge, which may occur in cycles

Physical Examination

• Red, thickened eyelids
• Dry crusting on the lid
• Acute hordeolum (stye)
• Occasionally conjunctivitis or corneal ulceration is seen.

Etiology

• Myriad, including acute infection with bacteria such as Staphylococcus aureus, Propionibacterium acnes, and Streptococcus epidermidis.
• Demodex folliculorum caused by a mite and inhabitant of human hair follicles, which may act as a vector for bacteria.
• Seborrhea

Diagnosis

Differential Diagnosis

• Acute or chronic conjunctivitis
• Contact dermatitis
• Preseptal cellulitis
• Sebaceous cell carcinoma (usually adults)

Workup

The diagnosis is usually made on physical examination.

Treatment

Nonpharmacologic Therapy

• Lid hygiene
• Warm compresses

Acute General Rx

• Topical antibiotic ointment (e.g., erythromycin) is applied to the lids.
• Topical antibiotic and a steroid combination ointment are used for resistant or severe cases.
• Oral antibiotic may be necessary.

Disposition

• As needed

Pearls & Considerations

Comments

• May be seen commonly with rosacea and Down syndrome

Patient/Family Education

Blepharitis is often a chronic disorder with periods of exacerbation requiring daily maintenance of nonpharmacologic therapy.

Suggested Readings

American Academy of Ophthalmology. Pediatric ophthalmology and strabismus, section 6. Basic and Clinical Science Course. Orlando, Florida: American Academy of Ophthalmology, 1998–1999.

Eliason JA. Blepharitis: overview classification. In: Krachmer JH, et al, editors. Cornea. St. Louis: Mosby, 1997.

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