Summary
Definition
History and exam
Key diagnostic factors
- burning sensation
- itching sensation
- foreign body sensation
- crusting of eyelids
- dry eye
- lid erythema, telangiectasias
- collarettes around lashes
- capped meibomian glands
- conjunctival hyperaemia
- unstable tear film with rapid tear break-up time
Other diagnostic factors
- chalazion
- scalp changes
- photophobia
- facial telangiectasias, erythema, pustules, papules
- depigmentation of lashes
- trichiasis
- madarosis
- lid margin thickening, notching, and ulceration
- corneal changes
- decreased vision
Risk factors
- age ≥50 years
- female
- dermatological disease
- intraocular or lid surgery/injury
Diagnostic investigations
Investigations to consider
- lid biopsy
- lid margin culture
- microscopic evaluation of epilated eyelashes
Treatment algorithm
no visual impairment
with visual impairment secondary to corneal involvement
refractory blepharitis
Contributors
Authors
Elaine Wu, MD
Assistant Professor of Ophthalmology
Kaiser Permanente
Union City
CA
Disclosures
EW declares that she has no competing interests.
Acknowledgements
Professor Elaine Wu would like to gratefully acknowledge Professor Esen Akpek, a previous contributor to this topic. EA declares that she has no competing interests.
Peer reviewers
Gus Gazzard, MA, MBBChir, MD, FRCOphth
Consultant Ophthalmic Surgeon
King's College Hospital
Honorary Research Fellow
Institute of Ophthalmology
London
UK
Disclosures
GG declares that he has no competing interests.
Leejee H. Suh, MD
Assistant Professor of Ophthalmology
Bascom Palmer Eye Institute
Miami
FL
Disclosures
LS declares that she has no competing interests.
Differentials
- Dry eye syndrome
- Chalazion
- Squamous cell carcinoma
More DifferentialsGuidelines
- Clinical management guidelines: blepharitis (lid margin disease)
- Preferred practice pattern: blepharitis
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