Blepharitis

Inflammation of the eyelid margins

It may due to either meibomian gland dysfunction (common, posterior blepharitis) or seborrhoeic dermatitis/staphylococcal infection (less common, anterior blepharitis). Blepharitis is also more common in patients with rosacea

The meibomian glands secrete oil on to the eye surface to prevent rapid evaporation of the tear film. Any problem affecting the meibomian glands (as in blepharitis) can hence cause drying of the eyes which in turns leads to irritation

PC - (Usually bilateral): gritty, itchy, dry sensation in the eyes and eyelid margins

Tx - hot compresses and gentle cleaning of eyelid margins to remove debris, use cotton wool dippied in stralised water and baby shampoo. Also lubricating eye drops can be used:

• Hypromellose is the least viscous. The effect lasts around 10 minutes.
• Polyvinyl alcohol is the middle viscous choice. It is worth starting with these.
• Carbomer is the most viscous and lasts 30 – 60 minutes.

It can be associated with dysfunction of the Meibomian glands, which are responsible for secreting oil onto the surface of the eye. It can lead to styes and chalazions

Stye

Hordoleum externum - Infection of the glands of zeis (sebaceous glands ar the base of the eyelashes) or glands of moll (sweat glands at the base of the eyelashes)

PC - Tender red lump along the eyelid that may contain pus

Tx - Hot compress and analgesia, Consider topic antibiotics (i.e. chloramphenicol) if it is associated with conjunctivitis or persistent.

Cholazion

Hordoleum internum - Occurs when a meibomian gland becomes blocked and swells up