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- Inflammatory or infectious process of the eyelid margin, typically involving skin, lashes, and meibomian glands
- Associated with itchiness, redness, flaking, and crusting of the eyelids
- Usually chronic, intermittent with exacerbations and remissions
- Typically bilateral
- No universal classification system
- Historically classified according to location, anterior versus posterior
- Anterior blepharitis: affects the base of the eyelashes and eyelash follicles
- Posterior blepharitis: affects the meibomian glands
- Can also be classified by etiology
- Inflammatory: seborrheic, meibomian gland dysfunction, allergic, associated with rosacea
- Infectious: bacterial (most commonly Staphylococcus aureus or Staphylococcus epidermidis), viral, fungal, or parasitic
One of the most common ocular disorders (37–47% of patients seen by ophthalmologists and optometrists)
- Presents in patients of all ages
- Mean age of presentation is age 50 years.
- No gender differences seen
- Presence of atopic, allergic, or seborrheic dermatitis
- Tear deficiency and dysfunction
- Contact lens use
- Isotretinoin used to treat severe cystic acne
- Less common risk factors include underlying immunologic disorders such as lupus, eyelid tumors, trauma, and other dermatoses.
- Results from the complex interplay between abnormal lid margin secretions, lid margin organisms, and dysfunction of the tear film
- Infectious blepharitis:
- Bacteria such as Staphylococcus may cause direct infection of the eyelids, evoke reaction to the exotoxin, or provoke an allergic reaction to the staphylococcal antigens.
- Inflammatory blepharitis:
- Inflammation of the meibomian glands leads to impaired gland secretions and instability of the tear film.
- This condition can have a direct toxic effect and promote bacterial overgrowth.
- Complex and poorly understood
- Likely multifactorial
- Infectious conditions
- Systemic diseases
- Environmental factors
- Posterior blepharitis more commonly associated with seborrhea or rosacea
Commonly Associated Conditions
- Seborrheic dermatitis
- Allergic or contact dermatitis
- Down syndrome (trisomy 21)
- Ocular rosacea
- Dry eye (keratoconjunctivitis sicca)