1.

Common Signs, Symptoms, and Complications of Blepharitis

Condition Symptoms Signs Complications

Staphylococcal Ocular Lid swelling; Bacterial
Blepharitis irritation/itching Erythema of lid conjunctivitis;
Foreign body margins; Scaly Hordeolum;
sensation collarets at base of Chalazion; Trichiasis;
Lids sticking together lashes; Staining, Madarosis; Ectropion;
erosion, and infiltrates Entropion
in lower third of
cornea
Seborrheic Blepharitis Mild forms often Greasy, foamy scales Tear film instability;
symptom free; at base of cilia; Periods of
Possible burning, Hyperemia of anterior exacerbation
stinging, itching lid margins
Seborrheic/ Mild to moderate Papillary and Secondary
Staphylococcal inflammation of lids follicular keratoconjunctivitis;
Blepharitis hypertrophy; Frequent exacerbation
Conjunctival
injection; Mixed lid
crusting
Meibomian Itching, tearing, Sudsy, foamy tears; Tear film instability
Seborrheic Blepharitis burning sensation Dilated meibomian
gland openings and
increased secretions
with acute
inflammation;
Conjunctival injection
Seborrheic Blepharitis Dry eye symptoms Blocked, inflamed Anterior seborrhea
with Secondary meibomian glands;
Meibomianitis Lipid secretions of
toothpaste
consistency; Unstable
tear film
Meibomian Severe inflammation Blocked meibomian Acne rosacea
Keratoconjunctivitis of lid margin gland openings;
Unstable tear film
Angular Blepharitis Inflammation of lids Lids dry and scaly, or Tear film instability
at outer canthus whitish frothy
discharge
Demodicosis Often symptom free; Cuffing at base of Granulomas in eyelid
Possible burning, lashes; Microscopic
itching, crusting of lid presence of mites
margin; Loss of lashes
 2. Frequency and Composition of Evaluation and Management Visits for Blepharitis

Type of Patient Frequency of History Slit Lamp Management Plan

Evaluation Biomicroscopy
Staphylococcal Twice a week Yes Yes Antibiotic or
Blepharitis until cleared, antibiotic/steroid ung. h.s.
then as to t.i.d., tear supplements
necessary p.r.n., steroid gtt. or ung. if
infiltrates; lid hygiene t.i.d.
until improved, then q.d.;
Patient counseling and
education
Seborrheic Weekly until Yes Yes Lid hygiene t.i.d. until
Blepharitis stable, then as improved, then daily;
necessary Patient counseling and
education
Seborrheic/ Twice a week Yes Yes Antibiotic or
Staphylococcal until controlled, antibiotic/steroid ung. h.s.
Blepharitis then every 6 mo to t.i.d., lid hygiene q.d. to
or as necessary t.i.d. for control; Patient
counseling and education
Meibomian Twice a week Yes Yes Lid hygiene up to t.i.d.,
Seborrheic until stable, then scalp shampoo q.d.,
Blepharitis as part of meibomian express q.d.,
preventive care antibiotic or
antibiotic/steroid ung. h.s.
to t.i.d.; Patient counseling
and education
Seborrheic Twice a week Yes Yes Lid hygiene up to t.i.d.,
Blepharitis with until stable (up antibiotic or
Secondary to 8 wks), then antibiotic/steroid ung. h.s.
Meibomianitis as part of to t.i.d., oral tetracycline or
preventive care doxycycline (taper); Patient
counseling and education
Meibomian Twice a week Yes Yes Lid hygiene, antibiotic or
Keratoconjunctivitis until stable (up antibiotic/steroid ung. h.s.
to 2 wks), then to t.i.d., oral tetracycline or
as part of doxycycline (taper); Patient
preventive care counseling and education

Sumber : American Optometric Asosiation

3. Pitcure of demodex on blepharitis

4. MGD ( Meibomian gland dysfunction)

MGD atau biasa disebut meibomian blepharitis atau disfungsi kelenjar meibom dalah
posterior blepharitis dimana ouput glandula meibom berkurang atau produksi yang tidak
normal dari kelenjar minyak.

Tanda dan gejalan nya antara lain :

 Inflamasi
 Thickened eyelid margins
 Eyelid crusting
 Burning
 Teraing
 Foreign body sensation
 Mdg kadang digambarkan sebagai sindroma mata kering yang disebabkan oleh disfungsi
dari kelenjar meibom.

Pada pasien disfungsi kelenjar Meibom, dikontrol dengan pembersihan kelopak

mata, bisa menggunakan tetrasiklin oral dan topikal antibiotic. Dosisiklin atau minosiklin
100 mg atau tetrasiklin 1000 mg dengan dosis terbagi bisa diberikan perhari dan bisa
dengan dosisiklin atau minosiklin 40-50 mg atau tetrasiklin 250-500 mg perhari setelah
menunjukkan perbaikan (biasanya 2-6 minggu). Bisa juga alternatif lain yaitu dengan
eritromisin oral (250-500 mg perhari) atau asitromisin (250-500 mg, 1-3x perminggu atau
1 g perminggu, untuk 3 minggu).

5. Dosis dan sediaan Doksisiklin

Sediaan : 100 mg
Dosis :
 Dewasa dan anak-anak > 8 tahun dengan BB > 45 kg
Dosisi awal : 100mg/12 jam
Dosis rumatan : 100 mg/hari
 Anak-anak usia > 8tahun dengan BB < 45kg
Dosis : 4,4mg/kgBB/hari dengan selang waktu 12 jam selama hari pertama
dilanjutkan dengan 2,2mg/kgBB sekali sehari.
 Dosis untuk infeksi berat : 200 mg/hari