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Blepharitis - External and Internal Eye
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Blepharitis - External and Internal Eye

Contributors: Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD, Lauren Patty Daskivich MD, MSHS
Other Resources UpToDate PubMed

Synopsis

Blepharitis, also referred to as meibomitis, is a chronic inflammatory condition of the eyelid margin. It is more common in individuals with light-skin phototypes and closely linked with dry eye syndrome. Patients will commonly describe foreign body sensation, burning, stinging, excessive tearing, eyelid erythema, and collections of matter around the eyelashes upon awakening. Although itching is more common in allergic eye disease, it can be present in blepharitis as well. Patients may also be prone to having multiple styes and chalazia on the eyelids.

Patients with chronic skin conditions such as rosacea, seborrheic dermatitis, and psoriasis are particularly prone to suffer from blepharitis. There are a number of causes of blepharitis in addition to the systemic skin conditions noted above, including meibomian gland dysfunction (meibomitis) and staphylococcal infection as well as infestation with Demodex mites (demodicosis).

Very severe blepharitis and associated dry eye can lead to ocular surface dysfunction and resultant progressive corneal and conjunctival scarring with peripheral vascularization of the cornea.

Codes

ICD10CM:
H01.009 – Unspecified blepharitis of unspecified eye, unspecified eyelid

SNOMEDCT:
41446000 – Blepharitis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:08/22/2019
Last Updated:02/09/2023
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Patient Information for Blepharitis - External and Internal Eye
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Contributors: Medical staff writer

Overview

Blepharitis is inflammation of the eyelids. When it involves the outside front of the eyelid, where the eyelashes are attached, it is called anterior blepharitis. Anterior blepharitis may be caused by:
  • Bacteria
  • Scalp dandruff (seborrheic dermatitis)
  • Allergy
  • Psoriasis
If blepharitis involves the inner eyelid, it is called posterior blepharitis. Posterior blepharitis may be caused by:
  • Dysfunction of the oil (meibomian) glands in the eyelid
  • Acne rosacea
  • Scalp dandruff (seborrheic dermatitis)
  • Allergy

Who’s At Risk

Although blepharitis is very common, people who have scalp dandruff (seborrheic dermatitis), dry skin, acne rosacea, contact allergies, diabetes, poor hygiene, or those sensitive to chemical irritants or cosmetic makeup are much more likely to suffer from blepharitis. Blepharitis is not contagious.

Signs & Symptoms

Typically, the eyelids are reddened ("red rims" as it is often called), swollen, and slightly warm, often with crusty debris (in the lashes, in the corner of the eyes, or on the lid edges). Burning, tearing, sensitivity to light, the feeling of a foreign body in the eye(s), sticking together of the lids, watery or mucous discharge, pain, blurry vision, and eye redness may all occur with blepharitis. Eye lashes may fall out or become twisted and possibly irritate the eye. Blepharitis may affect only one eye, but, usually, both eyes are involved.

Self-Care Guidelines

  • Apply frequent warm, moist compresses.
  • Clean the eyelids with baby shampoo and a wet cotton ball.
  • Practice good hygiene of the face and scalp, including use of antidandruff shampoo, if needed.
  • Make sure all makeup is removed daily.
  • Avoid any irritants that might cause blepharitis.
  • Keep underlying conditions controlled (eg, diabetes and acne rosacea).

When to Seek Medical Care

  • Pain is increasing.
  • Vision is worsening.
  • Swelling is increasing.
  • The eyelids become hot to the touch.
  • The condition is not getting better within a week despite self-care.
  • There is blistering and/or rash on the eyelids.
  • There is development of a lesion (bump or growth) on the eyelid that does not respond to the warm compresses.

Treatments

Typically, blepharitis is a chronic condition, but careful attention to daily hygiene and other preventive measures will reduce the recurrence rate.

References


Kanski JJ, Nischal KK, eds. Ophthalmology: Clinical Signs and Differential Diagnosis. pp. 14-15. Philadelphia: Mosby, 1999.

Wolff, Klaus, ed. Fitzpatrick's Dermatology in General Medicine. 7th ed, p. 224. New York: McGraw-Hill, 2008.
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Blepharitis - External and Internal Eye
A medical illustration showing key findings of Blepharitis : Bilateral distribution, Eye burning, Gritty eyes, Conjunctival injection, Ocular pruritus, Eye discharge
Clinical image of Blepharitis - imageId=486428. Click to open in gallery.  caption: 'Conjunctival infection on the inner eyelid and eye and surrounding scaling and erythema in a patient on medication.'
Conjunctival infection on the inner eyelid and eye and surrounding scaling and erythema in a patient on medication.
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