Blepharitis - External and Internal Eye
Alerts and Notices
Synopsis
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
- Meibomian gland dysfunction (see meibomitis)
- Ocular rosacea
- Allergic conjunctivitis or dermatitis
- Atopic keratoconjunctivitis
- Seborrheic dermatitis
- Dry eye syndrome
- Sebaceous cell carcinoma
- Ocular cicatricial pemphigoid
- Pediculosis
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.Subscription Required
References
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Last Reviewed:08/22/2019
Last Updated:02/09/2023
Last Updated:02/09/2023
Patient Information for Blepharitis - External and Internal Eye
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
- 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.
Blepharitis - External and Internal Eye