blepharitis

blepharitis /bleph·a·ri·tis/ (blef″ah-ri´tis) inflammation of the eyelids.

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blepharitis angula´ris  inflammation involving the angles of the eyelids.

blepharitis cilia´ris , marginal blepharitis a chronic inflammation of the hair follicles and sebaceous gland openings of the margins of the eyelids.

nonulcerative blepharitis , seborrheic blepharitis blepharitis with seborrhea of the scalp, brows, and skin behind the ears, marked by greasy scaling, hyperemia, and thickening.

ulcerative blepharitis  that marked by small ulcerated areas along the eyelid margin, multiple suppurative lesions, and loss of lashes.

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bleph·a·ri·tis (blf-rts)

n.

Inflammation of the eyelids.

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blepharitis

[blef′ərī′tis]

Etymology: Gk, blepharon + itis

an inflammatory condition of the lash follicles and meibomian glands of the eyelids, characterized by swelling, redness, and crusts of dried mucus on the lids. Ulcerative blepharitis is caused by bacterial infection. Nonulcerative blepharitis may be caused by psoriasis, seborrhea, or an allergic response.

observations Individuals report a foreign-body sensation of the eye. There are red eyelid margins, flaking and scaling around lashes, an itching and burning sensation, and loss of lashes. Light sensitivity, conjunctivitis, and possible corneal inflammation may also occur. In ulcerative blepharitis there are crusts on the eyelids, which bleed when removed. Small pustules develop in lash follicles, and eyelids become "glued" together by dried drainage during sleep. Lid margins thicken over time with misdirected growth and/or loss of eyelashes. Corneal pannus, ulcerative keratitis, and lid ectropion can occur in severe cases. Diagnosis is made by clinical examination, and lab tests may be run to isolate the causative agent. Individuals with chronic diseases, such as diabetes, gout, anemia, and rosacea, or a history of sties, chalazia, or chronic infections of the mouth and/or throat are at greater risk.

intervention Blepharitis is stubborn to treat and is often resistant to various therapies. Topical antiinfective ointments and drops are used, but the mainstay of treatment is the use of eyelid scrubs. Resistant cases may require oral antibiotic treatment.

nursing considerations Nurses need to provide individuals with detailed instructions in scrubbing and washing techniques. Eyelid hygiene consists of scrubbing the lid margins and lashes on closed eyelids daily and massaging lid margins to stimulate flow of secretions then cleansing with a cotton swab dipped in a diluted solution of baby shampoo. Careful instructions are needed for the application of antibiotic ointments to lid margins and drops to ocular surfaces. Individuals should also be instructed to use seborrheic dermatitis medicated shampoos and to apply hot compresses for 5 to 10 minutes to closed eyelids to loosen lid debris.

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blepharitis

inflammation of the eyelids. May be an extension of skin disease elsewhere on the face or body producing a blepharitis with similar characteristics, e.g. seborrheic, ulcerative, mycotic, etc.

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angular blepharitis

inflammation involving the outer angle of the eyelids.

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blepharitis 

Inflammation of the eyelids. The most common of these is marginal blepharitis. See meibomian glands; external hordeolum.
angular blepharitis Inflammation of the canthi, affecting especially the inner canthus.
marginal blepharitis Chronic inflammation of the eyelid margin accompanied by crusts or scales usually due to a bacterial infection (e.g. Staphylococcus aureus), an allergy, or to excessive secretion of lipid by the meibomian glands and the glands of Zeis (seborrhoeic blepharitis). The condition is commonly associated with keratoconjunctivitis sicca. Symptoms and signs include burning, itching, grittiness, and the eyelid is hyperaemic and crusted and usually worse in the morning. Treatment consists mainly of frequent cleaning of the lid margins with a cotton-tipped applicator (or face cloth or cotton ball) dipped in a diluted solution of baby shampoo; warm compresses and an antibiotic ointment (e.g. erythromycin) and occasionally systemic antibiotics such as tetracycline, especially in seborrhoeic blepharitis. In complicated cases, corticosteroids will also be used (Fig. B3). See acne rosacea; meibomian glands; glands of Zeis; meibomianitis; trichiasis.
posterior blepharitis Chronic inflammation resulting from dysfunction of the meibomian glands characterized either by excessive meibomian secretion (seborrhoeic blepharitis), which is frequently associated with seborrhoeic dermatitis involving the scalp, brows and ears, or inflammation and obstruction of the meibomian glands (meibomianitis).
seborrhoeic blepharitis See marginal blepharitis.
ulcerative blepharitis Inflammation of the eyelid margin characterized by small ulcers.

Fig. B3 Hard scales in staphylococcal blepharitis

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blepharitis

Blear eye Clinical medicine Chronic inflammation of the eyelids, with secretion of sebaceous material