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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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Dry Eye Led to Refractive Surgery
From Optometric Management, 11/1/05

Recently, I saw a 57-year-old woman with mild to moderate chronic dry eye disease. Her chief complaint was she was tired of her contact lenses becoming progressively more uncomfortable, resulting in decreased wearing time.

The patient reported her symptoms on my in-office dry eye questionnaire. After an exam, I noted she had vision fluctuations without contact lenses, and her best-corrected visual acuity varied between 20/25 and 20/40.

Other findings included:

* Decreased tear meniscus

* Poor meibomian gland expression

* Tear break-up time 6 to 8 seconds

* Superficial punctate keratitis, both eyes

* Irregular topography

* Schirmer test results of 7 mm in the right eye and 6 mm in the left eye.

These findings led me to diagnose the patient with blepharitis (ICD-9-CME 373.00) and with chronic dry eye disease or dry eye syndrome (ICD-9-CME 375.15). Armed with this diagnosis, I developed a comprehensive treatment regimen for her.

The treatment over 1 year included: Artificial tears; lid hygiene; warm compresses; a mild steroid four times a day for 2 weeks in both eyes; cyclosporine ophthalmic suspension 0.05% (Restasis) twice a day in both eyes; and punctal occlusion.

I saw this patient over the course of a year for follow-up visits and punctal occlusion. Treating her dry eye allowed a return to a healthier ocular surface.

She went on to have refractive surgery and is 20/25 OD and 20/20 OS and experiences dry eye symptoms only occasionally. Dry eye-related visits for this patient totaled $480 in revenue.

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

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