Inflammatory Disorders of eyelid

                                Inflammatory Disorders

Blepharitis is the inflammation of lid margin

Types:

Anterior

Posterior

Types of Anterior blepharitis

• Staphylococcal (Ulcerative or Infective)
• Seborrhoeic (Squamous or Non-Infective)

Staphylococcal Blepharitis

Caused by chronic infection of bases of lashes which leads to dermal and epidermal ulceration and tissue destruction

Examination

1.                              Redness of lid margin

2.                              Scaling which are hard situated around the bases of lashes. When removed Leave behind tiny bleeding ulcers

3.                              Tear film instability

4.                              Secondary changes due to hypersensitivity to staph. Exotoxins

a)                             Mild papillary conjunctivitis

b)                             punctate Keratitis

c)                              phlyctenulosis and corneal Vascularization

Complications:

·              Trichiasis

·              Madarsosis (Loss of lashes)

·              Poliosis (White lashes)

·              External hordeolum (Stye) due to spread of infection to glands of Zeis

·              Internal hordeolum due to spread infection to meibomian Glands

·              Bacterial conjunctivitis-spread of infection to conjunctiva

Treatment

·              Lid hygiene

·              Antibiotic Ointment

·              Weak topical steroid for Exotoxins

·              Artificial tears

Seborrhoeic blepharitis:-

·              Associated with Seborrhoeic dermatitis

Clinical Features and complications are same:

·              Scales are soft located any where along the lid margins and do not

bleed or leave ulcer behind.

Treatment

·              Same

·              Antidandruff shampoo.