Brief Description, Sign and Symptoms, Causes And Treatment Of Blepharitis

Blepharitis is an extremely common disease defined as a subacute or chronic inflammation of the lid margins. It is divided into following clinical types:

1. Seborrhoeic or squamous blepharitis.
2. Staphylococcal or ulcerative blepharitis.
3. Mixed staphylococcal with seborrhoeic blepharitis.
4. Posterior blepharitis or meibomitis.
5. 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

1. Apply hot compresses.
2. Remove scales and crusts with 3% sodium bicarbonate solution or diluted baby shampoo and if  nits are present, remove them with forceps.
3. Rub antibiotic ointments at the lid margins immediately.
4. Instill antibiotic eye drops 3-4 times daily.
5. In severe cases give oral antibiotics like tetracycline or erythromycin. Oral ibuprofen can also be given to reduce inflammation.
6. In cases of parasitic blepharitis, delouse the patient, family members, clothing and bedding