What is this Condition?
A common eye inflammation, especially in children, blepharitis produces a red-rimmed appearance on the margins of the eyelids. It often involves both eyes and can affect both upper and lower eyelids.
The two forms of the disorder are seborrheic (nonulcerative) blepharitis, characterized by greasy scales, and staphylococcal (ulcerative) blepharitis, in which dry scales with tiny ulcerated areas appear along the lid margins. Both types may coexist.
Blepharitis tends to recur and become chronic. It can be controlled if treatment begins before other eye structures are involved.
What Causes it?
Seborrheic blepharitis generally results from seborrhea of the scalp, eyebrows, and ears; staphylococcal blepharitis, from Staphylococcus aureus infection. Blepharitis may also result from infestations of body lice (pediculosis) on the brows and lashes, which irritates the lid margins.
What are its Symptoms?
Typically, the person complains of itching, burning, a foreign-body sensation, and sticky, crusted eyelids on waking. This constant irritation leads 10 unconscious rubbing of the eyes (causing reddened rims) or continual blinking. Other signs include greasy scales in seborrheic blepharitis; flaky scales on lashes, loss of lashes, and ulcerated areas on lid margins in staphylococcal blepharitis; and nits (louse eggs) on lashes if the person has pediculosis.
How is it Diagnosed?
Diagnosis depends on the person’s history and symptoms. In staphy-lococcal blepharitis, culture of the ulcerated lid margin shows S. aureus. In pediculosis, lash examination reveals nits.
How is it Treated?
Early treatment is essential to prevent recurrence or complications. Treatment depends on the type of blepharitis:
• seborrheic blepharitis: daily shampooing (using a mild shampoo on a damp applicator stick or a washcloth) to remove scales from the lid margins and frequent shampooing of the scalp and eyebrows
• staphylococcal blepharitis: sulfonamide eye ointment or an appropriate antibiotic
• blepharitis resulting from pediculosis: removal of nits (with forceps) or application of ophthalmic Eserine Sulfate or another ointment as an insecticide (this may cause pupil constriction and, possibly, headache, conjunctival irritation, and blurred vision from the film of ointment on the cornea).