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Blepharitis

Blepharitis is an eruption producing inflammation of eyelids and eyelashes. It is characterized by white flaky skin near the eyelashes. Blepharitis usually causes redness of the eyes and itching and irritation of the eyelids. more...

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There are two types. One, anterior blepharitis affects the front of the eyelids near the eyelashes. The causes are seborrheic dermatitis (similar to dandruff) and occasional infection by Staphylococcus bacteria. Two, posterior blepharitis affects the back of the eyelids, the part that makes contact with the eyes. This is caused by the oil glands present in this region

Staphylococcal blepharitis

Staphlycoccal blepharitis is a type of external eye inflammation. As with dandruff, it is usually asymptomatic until the disease progresses. As it progresses, the sufferer begins to notice a foreign body sensation, *mattering of the lashes, and burning. Usually, the primary care physician will prescribe topical antibiotics for staphylococcal blepharitis.

Seborrheic blepharitis

Seborrheic blepharitis, the inherited most common type of blepharitis, is usually one part of the spectrum of seborrheic dermatitis seborrhea which involves the scalp, lashes, eyebrows, nasolabial folds and ears. Treatment is best accomplished by a dermatologist.

Treatment and management

There is generally no cure for blepharitis, but it can be controlled by maintaining regular eyelid hygiene. Application of a damp warm cloth on the eyes helps unblock the Meibomian glands and this should be followed by firm massage of the eyelids with diluted baby shampoo, which acts as a mild cleaning agent. Antibiotic drops or ointments are prescribed in severe cases.

Dermatologists treat blepharitis similarly to seborrheic dermatitis by using safe topical anti-inflammatory medication like sulfacetamide or brief courses of a mild topical steroid.

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Punctal Occlusion for Periodic Double Vision
From Optometric Management, 11/1/05

A 75-year-old man came into my office with a case of severe chronic dry eye. His chief complaint was periodic double vision in one eye when looking at stop lights.

He also mentioned his eyes were always irritated. He was frustrated because he couldn't find a doctor who could tell him what was wrong or how to fix it.

I found this patient had no tear meniscus and no meibomian gland expression, but he did have extremely scalloped lid margins. His tear break-up time was 1 to 2 seconds, and he had superficial punctate keratitis (SPK) staining in both eyes, a Schirmer's result of 2 mm in both eyes and lissamine green staining of his conjunctiva and cornea.

Based on these results, I diagnosed acne rosacea (ICD-9-CME 695.3), blepharitis (ICD-9-CME 373.00) and chronic dry eye disease or dry eye syndrome (ICD-9-CME 375.15).

I then treated him with a comprehensive regimen of Refresh Liquigel as needed for symptomatic relief; lid hygiene; warm compresses to treat the blepharitis; erythromycin ointment (E-Mycin) at bedtime; an omega-3 fatty acid supplement; doxycycline 100 mg twice a day; a mild steroid four times a day for 3 weeks to treat initial inflammation; cyclosporine ophthalmic suspension 0.05% (Restasis) twice a day to increase natural tear production and punctal occlusion after 4 to 6 weeks to prevent drainage.

This patient required maximum therapy, including punctal occlusion in all four puncta, so I saw him frequently during the next year. He is still symptomatic but much more comfortable and now understands the disease process. Dry eye-related visits for this patient resulted in gross revenue of $1,020.

Copyright Boucher Communications, Inc. Nov 2005
Provided by ProQuest Information and Learning Company. All rights Reserved

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