Escolar Documentos
Profissional Documentos
Cultura Documentos
Introduction
Classification of Blepharitis
1. Anterior
Staphylococal
Seborrhoeic
Mixed
2. Posterior
Meibomian seborrhoea
Meibomianitis
3. Mixed Anterior and Posterior
1. Anterior Blepharitis
Long Standing
Staphylococcal Staphylococcal Blepharitis
Staphylococcal Blepharitis
Seborrhoeic
Mixed
Hyperemia,
Symptoms telangiectasia,
hypertrophy,
Burning, scarring
grittiness, mild lid
margin, andcrusting,
photophobia, madarosis in
rednessLong
of lidStanding
margin
Staphylococcal Blepharitis
Worse in the morning
Sign
Hyperemia, telangiectasia
Hard scales around bases of
eyelashes
1. Anterior Blepharitis
Staphylococcal
Seborrhoeic
Mixed
Sign
Hyperemic and greasy
anterior lid margin,
eyelashes are sticking
together
Soft scales
Assoc. with seborrhoeic
dermatitis
2. Posterior Blepharitis
Meibomian Meibomian Seborrhoea
Meibomianitis
seborrhoea (excessive meibomian
(Inflammation gland
and Obstruction
Meibomianitis secretion)
of Meibomian Glands)
Differential Diagnosis
1. Lid hygiene
To remove crust and toxic product
Using cotton bud and 25% solution of baby shampoo
2. Warm compress
To melt solidified sebum and mechanical expression of meibomian gland
3. Antibiotic ointment
Chloramphenicol or sodium fusidat (Fucidin) to treat acute foliculitis
4. Weak topical steroid
For secondary papillary conjunctivitis and marginal keratitis
5. Tear Substitutes
For tear film instability
6. Systemic antibiotics
For posterior blepharitis
Tetracycline (4x250 mg), doxycycline (2x100 mg), Minocycline (1x100 mg)
Erithromycin or Azithromycine if contraindicated
Treatment
Kanski JJ. Cilinical Ophthalmology A Systematic Approach. Butterworth Heinemann.
Philadelphia PA: Elsevier Science Limited. 2003
Ehlers JP, Shah CP. The Wills Eye Manual. Office and Emergency Room, Diagnosis
and Treatment of Eye Disease. 5th Ed. Philadelphia PA 19106 USA: Lippincott
Williams & Wilkins. 2008
References