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{{Blepharitis}}
{{Blepharitis}}
{{CMG}} {{AE}} {{SaraM}}
{{CMG}}; {{AE}} {{SaraM}}


==Overview==
==Overview==
Blepharitis is usually [[asymptomatic]] until the disease progresses. As it progresses, the patient begins to notice a [[foreign body]] sensation, and  eyelid crusting. Blepharitis can frequently be improved but are rarely eliminated. If left untreated, sever blepharitis may cause alterations in the [[eyelid margin]], loss of eyelashes, [[scarring]] of the [[eyelid]]s, [[conjunctivitis]], corneal involvement, superficial [[keratopathy]], and ultimately [[blindness]]. Common complications of blepharitis include [[Hordeolum]], chalazia, [[corneal ulcer]], [[conjunctivitis]], and loss of eyelashes.
Blepharitis is usually [[asymptomatic]] until the disease progresses. As it progresses, the patient begins to notice a foreign body sensation, eyelid crusting, [[itching]] and [[irritation]] of the eyelids. If left untreated, severe blepharitis may cause alterations in the eyelid margin, loss of eyelashes, scarring of the eyelids, [[conjunctivitis]], corneal involvement, superficial [[keratopathy]], and ultimately [[blindness]]. Common complications of blepharitis include loss of eyelashes, [[hordeolum]] or [[stye]], [[chalazion]], [[corneal ulcer]], and [[conjunctivitis]]. Blepharitis is generally associated with a favorable long-term prognosis.  
Blepharitis is a [[chronic]] condition. Blepharitis is associated with a favorable long-term prognosis. Severe blepharitis is rarely associated with permanent alterations in the [[eyelid margin]] or [[vision loss]] from superficial [[keratopathy]], [[corneal neovascularization]], and [[ulceration]], therefore these patients have a poor long term prognosisprognosis.


==Natural History==
==Natural History==
Blepharitis is often caused by an overgrowth of the [[bacteria]] (''[[Staphylococcus aureus]]''), and [[meibomian gland|meibomian gland dysfunction (MGD)]]. It is usually [[asymptomatic]] until the disease progresses. As it progresses, the patient begins to notice a [[foreign body]] sensation, eyelid crusting, matting of the lashes, [[tearing]], and burning. [[Symptoms]] are typically worse in the mornings. Blepharitis can frequently be improved but are rarely eliminated. If left untreated, sever blepharitis may cause alterations in the [[eyelid margin]], loss of eyelashes, [[scarring]] of the [[eyelid]]s, [[conjunctivitis]], corneal involvement ([[corneal neovascularization]] and [[corneal ulceration]]), superficial [[keratopathy]], and ultimately blindness.
Earlier in the course of blepharitis, patients may be asymptomatic and present with findings of eyelid margin telangiectasia and meibomian gland orifice narrowing.<ref>Hykin, P. G., and A. J. Bron. "Age-related morphological changes in lid margin and meibomian gland anatomy." Cornea 11.4 (1992): 334-342.</ref> As the disease progresses, patients usually develop symptoms of [[foreign body]] sensation, eyelid crusting, matting of the lashes, [[tearing]], and burning. If left untreated, blepharitis may lead to alterations in the eyelid margin, loss of eyelashes, [[scarring]] of the [[eyelid]]s, corneal involvement ([[corneal neovascularization]] and scarring), superficial [[keratopathy]], and eventually [[blindness]].<ref name="pmid21276617">{{cite journal| author=Nemet AY, Vinker S, Kaiserman I| title=Associated morbidity of blepharitis. | journal=Ophthalmology | year= 2011 | volume= 118 | issue= 6 | pages= 1062-8 | pmid=21276617 | doi=10.1016/j.ophtha.2010.10.015 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21276617  }} </ref><ref>Ficker L, Ramakrishnan M, Seal D, Wright P. Role of cell-mediated immunity to staphylococci in blepharitis. Am J Ophthalmol 1991;111:473-9.</ref>
Blepharitis is associated with exacerbation and remission as the natural history. Patients should be informed that symptoms can frequently be improved but are rarely eliminated.


==Complications==
==Complications==
Complications to viral conjunctivitis include:
Complications to blepharitis include:<ref name="pmid6743618">{{cite journal| author=Dougherty JM, McCulley JP| title=Comparative bacteriology of chronic blepharitis. | journal=Br J Ophthalmol | year= 1984 | volume= 68 | issue= 8 | pages= 524-8 | pmid=6743618 | doi= | pmc=1040405 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6743618  }} </ref><ref name=Blepharitis> PubMed Health (2009). http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0023008/ Accessed on July, 13 2016 </ref><ref name="pmid9640516">{{cite journal| author=Sharma S| title=Ophthaproblem. Chalazion. | journal=Can Fam Physician | year= 1998 | volume= 44 | issue=  | pages= 1249, 1254, 1257 | pmid=9640516 | doi= | pmc=2278269 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9640516  }} </ref>
* [[Hordeolum]]
* [[Hordeolum]] or [[stye]]
* Chalazia (usually painless [[firm lump]] caused by [[inflammation]] of the oil glands of the eyelid, and can be painful and red if there is also an infection)
* [[Chalazion|Chalazia]]  
* [[Corneal ulcer]]
* [[Corneal ulcer]]
* [[Conjunctivitis]]
* [[Conjunctivitis]]
* Loss of eyelashes
* [[Scarring]] of the [[eyelid]]s


==Prognosis==
==Prognosis==
Blepharitis is a [[chronic]] condition. Blepharitis is associated with a favorable long-term prognosis.
In general, blepharitis is associated with a favorable long-term prognosis.
 
Severe blepharitis is rarely associated with permanent alterations in the eyelid margin or [[vision loss]] from superficial [[keratopathy]]. However, severe blepharitis cases with these complications are generally associated with a poor p​rognosis​.<ref name="pmid22592706">{{cite journal| author=Lindsley K, Matsumura S, Hatef E, Akpek EK| title=Interventions for chronic blepharitis. | journal=Cochrane Database Syst Rev | year= 2012 | volume= | issue= 5 | pages= CD005556 | pmid=22592706 | doi=10.1002/14651858.CD005556.pub2 | pmc=4270370 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22592706  }} </ref><ref name="pmid1460262">{{cite journal| author=Raskin EM, Speaker MG, Laibson PR| title=Blepharitis. | journal=Infect Dis Clin North Am | year= 1992 | volume= 6 | issue= 4 | pages= 777-87 | pmid=1460262 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1460262 }} </ref>
Severe blepharitis is rarely associated with permanent alterations in the [[eyelid margin]] or [[vision loss]] from superficial [[keratopathy]], [[corneal neovascularization]], and [[ulceration]], therefore these patients have a poor long term prognosis.<ref name="pmid21276617">{{cite journal| author=Nemet AY, Vinker S, Kaiserman I| title=Associated morbidity of blepharitis. | journal=Ophthalmology | year= 2011 | volume= 118 | issue= 6 | pages= 1062-8 | pmid=21276617 | doi=10.1016/j.ophtha.2010.10.015 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21276617 }} </ref>


==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:Infectious disease]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Ophthalmology]]
[[Category:Ophthalmology]]
[[Category:Immunology]]
[[Category:Primary care]]
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{{WS}}

Latest revision as of 20:38, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]

Overview

Blepharitis is usually asymptomatic until the disease progresses. As it progresses, the patient begins to notice a foreign body sensation, eyelid crusting, itching and irritation of the eyelids. If left untreated, severe blepharitis may cause alterations in the eyelid margin, loss of eyelashes, scarring of the eyelids, conjunctivitis, corneal involvement, superficial keratopathy, and ultimately blindness. Common complications of blepharitis include loss of eyelashes, hordeolum or stye, chalazion, corneal ulcer, and conjunctivitis. Blepharitis is generally associated with a favorable long-term prognosis.

Natural History

Earlier in the course of blepharitis, patients may be asymptomatic and present with findings of eyelid margin telangiectasia and meibomian gland orifice narrowing.[1] As the disease progresses, patients usually develop symptoms of foreign body sensation, eyelid crusting, matting of the lashes, tearing, and burning. If left untreated, blepharitis may lead to alterations in the eyelid margin, loss of eyelashes, scarring of the eyelids, corneal involvement (corneal neovascularization and scarring), superficial keratopathy, and eventually blindness.[2][3]

Complications

Complications to blepharitis include:[4][5][6]

Prognosis

In general, blepharitis is associated with a favorable long-term prognosis. Severe blepharitis is rarely associated with permanent alterations in the eyelid margin or vision loss from superficial keratopathy. However, severe blepharitis cases with these complications are generally associated with a poor p​rognosis​.[7][8]

References

  1. ↑ Hykin, P. G., and A. J. Bron. "Age-related morphological changes in lid margin and meibomian gland anatomy." Cornea 11.4 (1992): 334-342.
  2. ↑ Nemet AY, Vinker S, Kaiserman I (2011). "Associated morbidity of blepharitis". Ophthalmology. 118 (6): 1062–8. doi:10.1016/j.ophtha.2010.10.015. PMID 21276617.
  3. ↑ Ficker L, Ramakrishnan M, Seal D, Wright P. Role of cell-mediated immunity to staphylococci in blepharitis. Am J Ophthalmol 1991;111:473-9.
  4. ↑ Dougherty JM, McCulley JP (1984). "Comparative bacteriology of chronic blepharitis". Br J Ophthalmol. 68 (8): 524–8. PMC 1040405. PMID 6743618.
  5. ↑ PubMed Health (2009). http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0023008/ Accessed on July, 13 2016
  6. ↑ Sharma S (1998). "Ophthaproblem. Chalazion". Can Fam Physician. 44: 1249, 1254, 1257. PMC 2278269. PMID 9640516.
  7. ↑ Lindsley K, Matsumura S, Hatef E, Akpek EK (2012). "Interventions for chronic blepharitis". Cochrane Database Syst Rev (5): CD005556. doi:10.1002/14651858.CD005556.pub2. PMC 4270370. PMID 22592706.
  8. ↑ Raskin EM, Speaker MG, Laibson PR (1992). "Blepharitis". Infect Dis Clin North Am. 6 (4): 777–87. PMID 1460262.
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