Last reviewed: 2 Sep 2023
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 hyperemia
- unstable tear film with rapid tear break-up time
More key diagnostic factors
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
Other diagnostic factors
Risk factors
- age ≥50 years
- female
- dermatologic disease
- intraocular or lid surgery/injury
More risk factors
Diagnostic investigations
Investigations to consider
- lid biopsy
- lid margin culture
- microscopic evaluation of epilated eyelashes
More investigations to consider
Treatment algorithm
ACUTE
no visual impairment
with visual impairment secondary to corneal involvement
ONGOING
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
- Preferred practice pattern: blepharitis
- Preferred practice pattern: blepharitis
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