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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The condition usually affects both eyes. Symptoms are worse in the morning; there may be several exacerbations and remissions (1).

  • If contact dermatitis is the cause there is generally a history of atopy or there may be other areas of the dermatitis due to the application of the cosmetics.

Symptoms include:

  • anterior blepharitis
    • may be asymptomatic
    • ocular discomfort, soreness, burning, itching, mild photophobia
    • symptoms of dry eyes - blurred vision, poor tolerance of contact lenses
  • posterior blepharitis
    • may be asymptomatic
    • ocular discomfort, soreness, burning, stinging
    • symptoms of dry eyes - blurred vision, poor tolerance of contact lenses

Signs include:

  • staphylococcal blepharitis (anterior blepharitis)
    • erythema, oedema and telangiectasiae of the lid margin
    • crusting of anterior lid margin (scales at bases of lashes) which may form collarettes which encircle the lashes
    • recurrent styes and chalazia (rarely)
    • aqueous tear deficiency
    • conjunctival hyperaemia
    • in severe and long standing disease there can be
      • trichiasis - misdirection of eyelashes towards the eye
      • poliosis - depigmentation of the eyelashes
      • madarosis - loss of eyelashes
      • eyelid ulceration and eyelid and corneal scarring may occur
  • seborrhoeic blepharitis (anterior blepharitis)
    • erythema, edema, and telangiectasia of the lid margins (changes are less marked than in staphylococcal blepharitis)
    • oily scale and greasy crusting on the lashes
    • conjunctival hyperaemia
    • aqueous tear deficiency
  • Demodex folliculorum mite infestation (anterior blepharitis)
    • lid margin erythema
    • “cylindrical dandruff” - characteristic clear sleeve (collarette) covers base of lash, extending further up the lash than flat staphylococcal rosettes
    • misalignment, trichiasis or madarosis could occur due to persistent infestation of the lash follicles
  • MGD (posterior blepharitis)
    • thick and/or opaque secretion at Meibomian gland orifices (which is difficult or impossible to express by finger pressure)
    • dilated gland and formation of microliths and chalazia - due to plugging of the ducts
    • telangiectasias and lid scarring may be present
    • excess lipid, foamy discharge (1)
    • conjunctival hyperaemia

Reference:


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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