- Seborrhoeic or squamous blepharitis.
- Staphylococcal or ulcerative blepharitis.
- Mixed staphylococcal with seborrhoeic blepharitis.
- Posterior blepharitis or meibomitis.
- Parasitic blepharits.
Seborrhoeic
In this type of blepharitis, white
dandruff-like scales appear on the lid margins and eyelashes. The patient
usually experiences watering eyes (lacrimation), irritation, falling of
eyelashes and on removal of the white dandruff-like scales show hyperemic
surface without ulcer. It is associated with seborrhoeic dermatitis.
Ulcerative (Bacterial)
This type comes with yellow
crusts at the root of cilia which glue them together and it can even glue the
upper and lower lids together especially when the patient wakes up in the
morning. On removal of the crusts, hyperemic surface with small ulcers is
observed. The patients experiences symptoms such as mild lacrimation,
irritation, itching, photophobia and redness of lid. These symptoms are usually
worse in the morning.
Meibomitis (Posterior)
This type is caused by either
bacterial infection or dysfunction of the meibomian gland. The meibomian gland
opening on lid margin is blocked with whitish form-like secretions which also
appears on the lid margin and canthi. The secretion squeezes out like tooth
paste when the eyelids is pressed. Meibomitis leads to low-quality tear (dry
eye).
Parasitic
This type is associated with demodex
folliculorum infection and phthiriasis palpebram due to crab-louse or
head-louse. It comes with the presence of nits on lid margins and root of
eyelashes.
Treatments Steps
- Apply hot compresses.
- Remove scales and crusts with 3% sodium bicarbonate solution or diluted baby shampoo and if nits are present, remove them with forceps.
- Rub antibiotic ointments at the lid margins immediately.
- Instill antibiotic eye drops 3-4 times daily.
- In severe cases give oral antibiotics like tetracycline or erythromycin. Oral ibuprofen can also be given to reduce inflammation.
- In cases of parasitic blepharitis, delouse the patient, family members, clothing and bedding
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