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Blepharitis

Last reviewed: 23 Jun 2024
Last updated: 21 Nov 2023

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
Full details

Other diagnostic factors

  • chalazion
  • scalp changes
  • contact lens intolerance
  • photophobia
  • facial telangiectasias, erythema, pustules, papules
  • depigmentation of lashes
  • trichiasis
  • madarosis
  • lid margin thickening, notching, and ulceration
  • corneal changes
  • decreased vision
Full details

Risk factors

  • Demodex infection
  • age ≥50 years
  • female
  • dermatologic disease
  • intraocular or lid surgery/injury
Full details

Diagnostic tests

Tests to consider

  • lid biopsy
  • lid margin culture
  • microscopic evaluation of epilated eyelashes
Full details

Treatment algorithm

ACUTE

no visual impairment

visual impairment secondary to corneal involvement

Contributors

Authors

Elaine Wu, MD

Ophthalmology Clinician

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.

Disclosures

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.

  • Blepharitis images
  • Differentials

    • Dry eye syndrome
    • Chalazion
    • Squamous cell carcinoma
    More Differentials
  • Guidelines

    • Meibomian gland dysfunction clinical practice guidelines
    • Clinical management guidelines: blepharitis (lid margin disease)
    More Guidelines
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