Blepharitis natural history, complications and prognosis
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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. 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 eyelids, conjunctivitis, corneal involvement, superficial keratopathy, and ultimately blindness. Common complications of blepharitis include loss of eyelashes, hordeolum, chalazion, corneal ulcer, and conjunctivitis. 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. Therefore, severe blepharitis is associated with a poor prognosis.[1][2][3]
Natural History
Blepharitis is often caused by an overgrowth of the bacteria (Staphylococcus aureus), and 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 eyelids, conjunctivitis, corneal involvement (corneal neovascularization and corneal ulceration), superficial keratopathy, and ultimately blindness. 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.[1][4]
Complications
Complications to blepharitis include:[2][4][5]
- Hordeolum
- Chalazia
- Corneal ulcer
- Conjunctivitis
- Loss of eyelashes
- Scarring of the eyelids
Prognosis
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 prognosis.[3][6]
References
- ↑ 1.0 1.1 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.
- ↑ 2.0 2.1 Dougherty JM, McCulley JP (1984). "Comparative bacteriology of chronic blepharitis". Br J Ophthalmol. 68 (8): 524–8. PMC 1040405. PMID 6743618.
- ↑ 3.0 3.1 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.
- ↑ 4.0 4.1 American Academy of Ophthalmology/ eyewiki (2014) http://eyewiki.aao.org/EyeWiki%3AGeneral_disclaimer%7C Accessed on July 14, 2016
- ↑ Sharma S (1998). "Ophthaproblem. Chalazion". Can Fam Physician. 44: 1249, 1254, 1257. PMC 2278269. PMID 9640516.
- ↑ Raskin EM, Speaker MG, Laibson PR (1992). "Blepharitis". Infect Dis Clin North Am. 6 (4): 777–87. PMID 1460262.