The eyelids become swollen and have ulcerative, non-healing areas that may even bleed. There is a yellowish sticky discharge which is more abundant in the morning and cause eyelid matting of the eyelashes. The other symptoms include itching, burning, gritty and foreign body sensation in the eyes.

Vision is usually not affected in blepharitis, although a poor tear film result into blurring of vision and sensitivity to light. The chronic inflammation of blepharitis can cause redness of the eyes.
In allergic blepharitis, the eyelids may appear dark. This condition is called “allergic shiner” and which tends to be more frequent in children as compared to adults.

Untreated cases of blepharitis can also present with various complications like stye, chalazion, trichiasis or even loss of eyelashes. Conditions like entropion and ectropion are not commonly associated with blepharitis.

• Alopecia

  Abstract An immune deficiency state is proposed as the cause of a disorder affecting a father and son with chronic dermatitis, purulent blepharitis with corneal ulceration, and scarring pyodermatous alopecia of the scalp. [ncbi.nlm.nih.gov]

  Patients may exhibit alopecia areata of eyelashes and/or growth misdirection, trichiasis. [en.wikipedia.org]

• Blepharitis

  Symptoms and signs of blepharitis are often erroneously ascribed by the patient as "recurrent conjunctivitis".[11] Staphylococcal blepharitis and Posterior blepharitis or rosacea-associated blepharitis Symptoms Symptoms include a foreign body sensation [en.wikipedia.org]

  Blepharitis may be acute (ulcerative or nonulcerative) or chronic (meibomian gland dysfunction, seborrheic blepharitis). [merckmanuals.com]

  Blepharitis — 2013. San Francisco, Calif.: American Academy of Ophthalmology. . Accessed Feb. 6, 2015. Shtein RM. Blepharitis. . Accessed Feb. 6, 2015. Facts about blepharitis. National Eye Institute. . Accessed Feb. 6, 2015. Blepharitis. [mayoclinic.org]

• Photophobia

  Average subjective symptom grading improved statistically after treatment with oral azithromycin, except for eyelid hyperemia, photophobia, and foreign body sensation. [ncbi.nlm.nih.gov]

  Blepharitis Symptom Light Sensitivity (Photophobia) Sensitivity to light is the inability to tolerate light, medically known as photophobia. [medicinenet.com]

  Symptoms include itching of the eye, a burning sensation in the eye, excessive tear production, photophobia, swollen and red eyelids, sticky eyelids, and crusting and loss of the eyelashes. Blepharitis typically is chronic and difficult to treat. [britannica.com]

• Lacrimation

  Instead, it is likely an adaptive response of the ocular surface to the lack of tears, possibly increasing meibum fluidity, thus enhancing lacrimal film stability. [ncbi.nlm.nih.gov]

  ICD-10-CM Codes › H00-H59 Diseases of the eye and adnexa › H00-H05 Disorders of eyelid, lacrimal system and orbit › H01- Other inflammation of eyelid › Unspecified blepharitis unspecified eye, unspecified eyelid 2016 2017 2018 2019 Billable/Specific Code [icd10data.com]

  Symptoms and Signs Symptoms common to all forms of blepharitis include itching and burning of the eyelid margins and conjunctival irritation with lacrimation, photosensitivity, and foreign body sensation. [merckmanuals.com]

  Ocular Anatomy 11 Orbital Anatomy Adnexal Structures 3 Eyelids Lacrimal Gland Lacrimal Drainage Apparatus Eyeball 3 Globe Structures Extraocular Muscles Refractive Errors Visual Pathway 3 Optic Nerves And Chiasm Optic Tracts And Radiations Visual Cortex [ophthalmologytraining.com]

• Eye Pain

  American Academy of Ophthalmology 655 Beach Street Box 7424 San Francisco, CA 94120 415-561-8500 American Academy of Ophthalmology How Do You Treat Eye Pain? If you have eye pain, call your doctor for an evaluation. [emedicinehealth.com]

  Some Conditions Affect Eyelashes, Eyelids Blepharitis and meibomitis are conditions of the eyelashes and eyelids that can cause itching, redness, irritation, burning, blurred vision and/or eye pain. [nweyes.com]

  For example, if you have eye pain or a lot of swelling and redness, you may need to see a doctor for treatment. While your eyelids are healing, it may be a good idea to avoid wearing contact lenses or eye makeup. [northshore.org]

• Thickened Eyelids

  Posterior blepharitis also leads to thickened eyelid margins and crusty eyelids. [midohioeye.com]

  Clogging of the glands can result in thickened eyelid margins and crusty eyelids. Mixed blepharitis is when anterior and posterior types occur at the same time. [belmarrahealth.com]

  While patients present with similar signs and symptoms as anterior, they also often demonstrate other signs including inspissations of the meibomian glands, telangiectasia and thickened eyelid margins (Figure 2). [healio.com]

  Signs (observations that one makes) of blepharitis include red eyelid margins, swollen eyelids, thickened eyelids, increased shedding of skin cells near the eyelids, causing flaking of the skin around the eyes, matting of the lashes or eyes appearing [medicinenet.com]

Thorough careful routine examination of the eyelids and eyelashes is usually sufficient to establish the diagnosis of blepharitis [7]. Further tests and procedures used to diagnose blepharitis include the following.

Examination of eyelids: Blepharitis can be diagnosed by routine examination of eyelids and eyelashes. A slit lamp microscope can be used for detailed examination of cornea, iris and lens under high magnification.

Skin swab for test: In certain cases, a swab can be used to collect a sample of oil or crusts that is formed on eyelids. This sample can be used to analyze bacterial, fungal or allergic cause of blepharitis.

• Penicillium

  The isolated fungi were Penicillium species (2 cases), Candida species (1 case), and Trichophyton verrucosum (1 case). Direct microscopic examination revealed Demodex mites in 42.1% of the blepharitis group. [ncbi.nlm.nih.gov]

Blepharitis can be treated through proper eyelid hygiene. If left untreated, it can lead to severe complications. Treatment of blepharitis consists of the following elements.

• Cleaning of the eyes: Carefully clean the eyelids with a warm wash cloth for about 2 minutes. The edges of the eyelids can be gently scrubbed with tearless shampoo to remove the lid margin debris. Warm compresses applied to the eyelids can loosen crusted secretions. The procedure should be repeated several times a day until the symptoms are resolved.
• Antibiotics: After cleaning of the lid margins, a small amount of antibiotic ointment can be applied to treat bacterial infection. The antibiotics most commonly used include erythromycin, sulphacetamide, doxycycline and tetracycline etc. These can be administered in cream, ointment or pill form. Ulcerative forms of blepharitis may require antibiotic injection in the ciliary edges of the lids [8].
• Steroid eye drops: The corticosteroids are helpful to control inflammation of eyelids. In corneal disease, they may be combined with antibiotics [9].
• Artificial tears: In certain cases, eyes become dry due to poor tear film. Lubricating eye drops or artificial tears can help prevent dry eye syndrome.
• Control dandruff: In patients with seborrheic dermatitis or dandruff, there is a need to use an anti-dandruff shampoo on the scalp and eyebrows. And similarly, if lice are the cause, petroleum jelly can be applied along the base of eyelashes to prevent them.
• Nutritional support: A diet rich in Omega-3 fatty acids or supplements containing Omega-3 fatty acids may also help prevent blepharitis [10].

Despite proper treatment, the disease may recur in certain cases.

Overall, the prognosis for patients with blepharitis is good. Blepharitis usually responds to treatment, but in some cases the disease may recur and develop into chronic blepharitis. Chronic blepharitis is usually resistant to treatment and can lead to complications. In severe cases, patients may develop corneal complications which can cause loss of vision.

Blepharitis can result from many causes. The most common of them is bacterial infection causes by staphylococcal species [1]. Seborrheic dermatitis is most commonly caused by dandruff of the scalp and eyebrows [2].

Allergic reactions caused by medications, contact lenses or eye makeup may also result in blepharitis [3]. Poor nutrition and poor hygiene can be a contributory factor for the development of blepharitis. Eyelash mite or lice can also cause blepharitis [4] [5] [6].

Moreover, certain medications such as isotretinoin can also lead to an increase in the number of bacteria on eyelids, thus increasing the risk for the development of blepharitis.

Blepharitis is a common eye disorder throughout the world. There are no racial differences in the incidence of blepharitis, and the disease is found equally in both men and women. It affects people of all ages; however, seborrheic dermatitis is seen more frequently in an older age group.

Blepharitis is most commonly caused by bacterial infection. The microbial invasion into tissues causes an inflammatory processes. This is the release of a number of bacterial toxins, chemical mediators and enzymes. The eyelid tissues being sensitive to the toxins secreted by these bacteria result into a thick, sticky discharge which may cause the eyelids to stick overnight.

The meibomian glands found in the lids produce secretions that maintain the outer lipid layer in the lid. This lipid layer reduces the evaporation of the aqueous component of tears. In patients with blepharitis, there is an obstruction in the meibomian gland ducts that reduces the amount of lipid secretion. This can result in increased evaporation of the aqueous component, leading to dry eyes.

The most effective way to prevent blepharitis and its recurrence is to keep the eyelids and face clean. Care must be taken to avoid exposure to smoke and chemical fumes, and exposure to sunlight should be avoided as well while taking antibiotics. The use of an anti-dandruff shampoo may help prevent blepharitis if dandruff is contributing to the blepharitis. The use of eye makeup should also be avoided to prevent further irritation.

Blepharitis is the inflammation of the eyelids that usually involves the lower part of the lids and eyelashes. It is characterized by itching, burning, swelling and redness in both eyes, excessive tear production and loss of eyelashes. It is the most common eye disease.

Blepharitis  may be classified into seborrheic, ulcerative, staphylococcal and parasitic varieties. It is sometimes a chronic condition that can be difficult to treat, but it does not usually affect vision or damage the eye.

Blepharitis is the swelling and irritation of the eyelids. The patients usually have red and itchy and eyelids. It is a common disorder that can occur in people of any age. With proper treatment, eyelid hygiene and lifestyle changes, the disease has a good prognosis.

1. Vena Rodriguez A. [Etiology of blepharitis]. Medicamenta. Feb 10 1951;9(195):121-122.
2. Thygeson P, Vaughan DG, Jr. Seborrheic blepharitis. Transactions of the American Ophthalmological Society. 1954;52:173-188.
3. Lemp MA. Contact lenses and associated anterior segment disorders: dry eye, blepharitis, and allergy. Ophthalmology clinics of North America. Sep 2003;16(3):463-469.
4. Pinckney J, 2nd, Cole P, Vadapalli SP, Rosen T. Phthiriasis palpebrarum: a common culprit with uncommon presentation. Dermatology online journal. 2008;14(4):7.
5. Divani S, Barpakis K, Kapsalas D. Chronic blepharitis caused by Demodex folliculorum mites. Cytopathology : official journal of the British Society for Clinical Cytology. Oct 2009;20(5):343-344.
6. Dhingra KK, Saroha V, Gupta P, Khurana N. Demodex-associated dermatologic conditions--A coincidence or an etiological correlate. Review with a report of a rare case of sebaceous adenoma. Pathology, research and practice. 2009;205(6):423-426.
7. Jackson WB. Blepharitis: current strategies for diagnosis and management. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie. Apr 2008;43(2):170-179.
8. Enaliev FS. [Treatment of ulcerative blepharitis by injections of antibiotics into the region of ciliary edges of the lids]. Vestnik oftalmologii. May-Jun 1966;79(3):77-78.
9. Luchs J. Efficacy of topical azithromycin ophthalmic solution 1% in the treatment of posterior blepharitis. Advances in therapy. Sep 2008;25(9):858-870.
10. Macsai MS. The role of omega-3 dietary supplementation in blepharitis and meibomian gland dysfunction (an AOS thesis). Transactions of the American Ophthalmological Society. 2008;106:336-356.