4 steps to beating blepharitis
You won’t find it if you aren’t looking for it
Blepharitis is an inflammatory condition of the eyelids leading to red, irritated, itchy, and dandruff-like scales that form on the eyelashes. It is a common eye disorder caused by bacteria or a skin condition, such as dandruff of the scalp or acne rosacea.1 No matter the cause, the only way we can beat blepharitis is to determine the location as anterior, posterior, or mixed; differentiate among the causative factors, and treat according to the severity of the condition.
Differentiate and understand presentation differences
The first step in addressing blepharitis is to differentiate and understand the differences among the presentations. The term “blepharitis” has been commonly referred to as a single disease state; however, there are multiple presentations which are not the same at all. To complicate things further, there is inconsistency in terminology in addition to challenges related to overlap with other ocular surface diseases such as dry eye disease and allergic conjunctivitis. All three may present with similar signs and symptoms which, if not properly identified, will not be optimally treated.
Related: Understanding and defining MGD
Anterior blepharitis is an inflammation of the eyelid margin anterior to the gray line and concentrated around the lashes.2 The condition is typically associated with gram-positive bacteria, most commonly staphylococcal infections (Staphylococcus aureus and Staphylococcus epidermis). Other causes include dry eye disease, Demodex mite infestations, rosacea, seborrheic dermatitis, isotretinoin, and giant papillary conjunctivitis.3 Typical clinical findings include debris or collarettes at the base of the eyelashes, erythema, and edema of the lid margin. Symptoms and presentation can be acute or chronic.