Blepharitis (Yumori)

Question 1

Anterior blepharitis

Answer 1

irritation and inflammation at the base of the eyelashes caused by bacteria (staphylcoccal or seborrhoeic)

Question 2

Blepharitis: symptoms

Answer 2

burning, grittiness, associated dry eye symptoms

Question 3

ANterior Blepharitis: Signs

Answer 3

• Staphylococcal signs include: collarettes, increased vascularization, trichiasis and irregular lid margin
• Seborrhoeic signs include: greasy anterior lid margins, stuck together lashes, soft scales

Question 4

bleph treatment: eyelid therapy

Answer 4

use a washcloth to wipe gently against lashes and lid margins. in the shower, with your eyes closed, wash the base of your lashes with a washcloth. Can also treat with topical antibiotic ointment (erythromycin or bacitracin oph ung OHS OU)

Question 5

What should you be careful of with blepharitis?

Answer 5

intractable, unilateral, or asymmetric belpharitis: may be a manifestation of sebaceous carcinoma of the eyelid

Question 6

Posterior blepharitis (Meibomitis)

Answer 6

caused by: meibomian gland dysfunction, changes in meibum. Leads to: ocular surface irritation, increased tear evaporation, hyperosmolarity, unstable tear film (TBUT)

Question 7

Posterior bleph symptoms

Answer 7

burning, grittiness, associated dry eye symptoms

Question 8

Meibomitis signs

Answer 8

expressibility (%glands secreting), secretion quality (clear vs white). You have to push!

Question 9

Meibomitis treatment

Answer 9

1. Warm compresses twice a day. Place heated mask over eyelids for 5-10min/session with your eyes closed. don’t put pressure on eyes
2. Eyelid massages: pinch gently along the eyelid margin (base of lashes)
3. Oral tetracyclins: reduces lid and conj bacteria load, decreases keratinization and bacterial lipase production, reduce matrix metalloprotinase activity

Question 10

Oral tetracyclins for meibomitis

Answer 10

doxycycline 50mg qd, tetracycline 250-500mg qd

contraindicated in pregnant/nursing women and children use erythromycin 200mg BID