Last reviewed: 29 Oct 2021
Last updated: 11 May 2021

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

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.

Use of this content is subject to our disclaimer