Blepharitis
Blepharitis is inflammation of the edges of the eyelids, possibly with thickening scales, crusts, shallow ulcers, or inflamed oil glands at the edges of the eyelids.
Disorders that may cause blepharitis include staphylococcal infection of the eyelids or the ducts of the deeper glands that open at the edges of the eyelids, seborrheic dermatitis of the face and scalp, and acne rosacea.
Blepharitis may produce the feeling that something is in the eye. The eyes and eyelids may itch and burn, and the edges of the eyelids may become red. The eyes may become watery and sensitive to bright light. The eyelid may swell, and some of the eyelashes may fall out. Sometimes, small abscesses containing pus (pustules) develop in the sacs at the base of the eyelashes and eventually form shallow ulcers (ulcerative blepharitis). A crust may form and stick tenaciously to the edges of the eyelid; when the crust is removed, it may leave a bleeding surface. During sleep, secretions dry and make the eyelids sticky.
Blepharitis tends to recur and stubbornly resist treatment. It is inconvenient and unattractive but usually does not damage the cornea or result in loss of vision. Occasionally, ulcerative blepharitis can result in a loss of the eyelashes, scarring of the eyelid margins, and even damage to the cornea.
Diagnosis is usually based on the symptoms and the appearance of the eyelids. A doctor may use a slit lamp to examine the eyelids more closely. Occasionally, a sample of pus is taken from the edges of the eyelids and is cultured to identify the type of bacteria responsible and the antibiotics to which they are susceptible.
For blepharitis caused by seborrheic dermatitis, treatment usually consists of keeping the eyelids clean by gently scrubbing the edges of the eyelids each day with a wash cloth or cotton swab dipped in a dilute solution of baby shampoo (two to three drops in ½ cup of warm water). For inflamed oil glands at the edge of the eyelids, warm compresses may ease the itching and burning. Occasionally, a doctor may prescribe an antibiotic ointment, such as bacitracin plus polymyxin B or sulfacetamide, or an oral antibiotic, such as doxycycline. When seborrheic dermatitis is the cause, the face and scalp must be treated as well (see Section 18, Chapter 203). If acne rosacea is the cause, it can be treated.
|
