Acute or Chronic Eyelid inflammation

surrounding the lid margin, eyelashes, glands,

and sclera.
Infectious and non-infectious forms.
Sign and Symptoms
foreign body or burning sensation, excessive tearing,
itching, sensitivity to light (photophobia), red and
swollen eyelids, redness of the eye, blurred vision,
frothy tears, dry eye, or crusting of the eyelashes on
awakening


Complication:
Stye: A sty or hordeolum is a bacterial infection in one of
the oil glands whose opening is clogged. The result is a
painful lump on the edge or inside of your eyelid.
Chalazion: A chalazion or conjunctival granuloma occurs
when a blockage in one of the oil glands causes that gland
to become enlarged and scarred.
Chronic pink eye: Blepharitis can lead to recurrent bouts
of pink eye (conjunctivitis).
Ulceration of the cornea: Constant irritation from
inflamed eyelids or misdirected eyelashes may cause a
sore (ulcer) to develop on your cornea.


Anterior Blepharitis (Staphylococcal
blepharitis )
Inflammatory condition of outside portion of eyelids
Secondary to infection of Staphylococcal bacteria or
associated with acne rosacea or seborrheic dermatitis
of scalp or facial areas.
Sign: presence of a collarette (a ring-like formation
around the lash shaft) and include loss of eyelashes
or broken eyelashes.
More common among woman than man
Mainly diagnose upon Medical History, Physical
Examination and Bacterial Culture


Seborrheic blepharitis
caused by seborrheic dermatitis, a skin condition
that creates flaking and scaling including on the
eyelids.
Seborrheic dermatitis appears in a person with a
weakened immune system. Fungi or certain types of
yeast that feed on oils (lipids) in the skin also may
lead to seborrheic dermatitis, with accompanying
blepharitis.

Rosacea blepharitis
a component of ocular rosacea.
Eyelid inflammation linked to dysfunction of the
skin's oil (sebaceous) glands.
Acne rosacea is a common skin inflammation
characterized by pimple-like bumps and facial
redness especially around the cheeks, nose,
forehead and chin

Posterior Blepharitis (Meibomian Blepharitis)
Tissue inflammation of the inside portion of the
eyelids
Associated with altered complication of meibomian
gland secretions, inflammation of local tissue.
It reduces meibomian gland output or produces
abnormal oily secretions
Symptoms: inflamed and thickened eyelid margins,
eyelid crusting. Dry eye symptoms including
burning, foreign body sensation, and contact lens
intolerance
Excess oil production reduces the lipid layer of the tear
film promotes the formation of a crusty debris in and
around the meibomian glands clogs the meibomian orifices,
or at the very least interferes with meibomian secretions.
These oily deposits on the lid margin provide bacteria with
an ideal environment for infestation and multiplication of
Staphylococcal infection often accompanies and exacerbates
seborrheic blepharitis.
In infectious blepharitis, bacterial exotoxins called lipases
break down the cholesterol compounds within the
meibomian secretions. This frees fatty acids, which are
directly toxic to the corneal epithelium, resulting in punctate
epitheliopathy and inflammation. Disturbance to the lipid
layer increases tear evaporation and subsequently promotes
dry eye.

The mainstay of therapy is improved lid hygiene.
Sulfa drugs (i.e., sulfacetamide) are the classic
medications for treating Staphylococcal infection.
These work by competitive inhibition of para-
amino benzoic acid (PABA), which inhibits cellular
processes of the bacteria.
For case of resistance to sulfa drugs, other
acceptable preparations include gentamicin,
tobramicin, erythromicin and neomycin,
polymyxin B and bacitracin, prescribed BID/QID
in either ointment or drop form.

For excessive inflammation and/or discomfort,
tobramycin and dexamethasone alcohol (Tobradex)
neomycin or polymyxin B with hydrocortisone
(Cortisporin)
neomycin or polymyxin B with dexamethasone (Maxitrol)
sulfacetamide and prednisolone acetate (Blephamide)
sulfacetamide & prednisolone sodium phosphate
(Vasocidin)
In recalcitrant cases, oral tetracycline, 250 to
500mg, BID or QID. it inhibits the bacterial
production of lipases, which increases stability of
the tear film.