Etiology and Treatment of Blepharitis

Thygeson, Phillips

doi:10.1001/archopht.1946.00890210453002

Cited by 47 publications

(10 citation statements)

References 17 publications

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“…Clinically, blepharitis can be categorized under Staphylococcic blepharitis, seborrheic blepharitis, and mixed forms of primary blepharitis. 4 These can be further classified into anterior and posterior blepharitis, where anterior affects the anterior lid margins and eyelash base, and posterior involves the posterior lid margin, commonly associated with abnormalities of the Meibomian glands. In most cases, patients are diagnosed with a mix of both anterior and posterior blepharitis, and present with chronic inflammation of the lid margins.…”

Section: Discussionmentioning

confidence: 99%

Bloody tears: a case of bilateral ulcerative blepharitis

2018

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Chronic blepharitis leading to bilateral ulceration is rare to encounter. A 49-year-old African American female presents with bloody tears, severe pain, and photophobia in both eyes. Clinical presentation called for ulceration on the upper lid margins with excavated wound which bled on gentle rubbing. A systemic health review in combination of the symptoms and clinical picture led to the diagnosis of severe ulcerative blepharitis. Immediate oral antibiotics were started along with topical antibiotic cream. Ulcerative blepharitis can be easily misdiagnosed with sebaceous cell carcinoma. The pathophysiology of ulcerative blepharitis points to synergy between infectious entity and inflammatory aetiology, with either bacterial or fungal microorganisms as the trigger agents. Almost all cases of ulcerative blepharitis should include a dermatological evaluation given there is a strong association between ulcerative blepharitis and atopic dermatitis.

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Section: Discussionmentioning

confidence: 99%

Bloody tears: a case of bilateral ulcerative blepharitis

2018

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“…More than half a century ago, it was reported that yeasts may play a role in the pathogenesis of both seborrheic dermatitis and blepharitis. 13 Since then, there are few reports in the literature demonstrating fungi as a cause of chronic blepharitis. [14][15][16] We were able to find only one clinical trial in our search of the literature, in which antifungal treatment of patients with seborrheic blepharitis yielded better results when compared with the conventional therapy.…”

Section: Discussionmentioning

confidence: 99%

Periodic acid–Schiff staining demonstrates fungi in chronic anterior blepharitis

Dadacı

Kılınç

Özer

et al. 2015

Eye

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Purpose To evaluate the presence of fungi in patients with chronic anterior blepharitis with periodic acid-Schiff (PAS) staining of the eyelashes in addition to the conventional methods of fungal cultures and direct microscopy. Methods Nineteen patients with chronic anterior blepharitis of seborrheic or mixed seborrheic/staphylococcal type and 11 healthy age-and sex-matched controls were included in this prospective, nonrandomized, cross-sectional study. Blepharitis was diagnosed based on clinical evidence of greasy scales between the cilia, lid margin erythema, conjunctival hyperemia, telangiectasia, thickening, or irregularity of the eyelid margins by slit-lamp biomicroscopy. Eyelash samples were obtained by epilation with a sterile forceps and evaluated with PAS staining, fungal cultures, and direct microscopy. Results We demonstrated fungal elements with PAS staining in 79% of the blepharitis group (hyphae and/or spores) and 18% of the control group. The difference was statistically significant (P = 0.002). Four patients in the blepharitis group (21%) had positive cultures for fungi. The isolated fungi were Penicillium species (2 cases), Candida species (1 case), and Trichophyton verrucosum (1 case). Direct microscopic examination revealed Demodex mites in 42.1% of the blepharitis group. No culture growth or Demodex mites were observed in the control group. Conclusions We have shown fungi with PAS staining in the majority of patients with chronic anterior blepharitis. Further controlled studies are necessary to clarify the role of fungi in the etiopathogenesis of blepharitis.

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“…The older literature generally refers to S. aureus as the causative agent in bacterial blepharitis (1,17,18); however, more recently, the pathogenic properties and causative role of the coagulase-negative staphylococci have been recognized (2-4, 7, 8, 11, 13, 14, 19). Although generally regarded as normal endogenous microflora, S. epidermidis has been implicated as the causative agent of blepharitis in 50, 69, and 86% of cases in three series (9,13,19).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of mercuric oxide in the treatment of bacterial blepharitis

Hyndiuk

Burd

Hartz

1990

Antimicrob Agents Chemother

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A double-masked, placebo-controlled, randomized study was done to assess the safety and clnical and quantitative microbiologic efficacy of 1% mercuric oxide (yellow) ophthalmic ointment in the treatment of eyelid infections, i.e., bacterial blepharitis. A total of 39 patients with bacterial counts and clnal signs indicative of eyelid infection were treated twice daily for 7 days. Clinical biomicroscopic exmination and quantitative microbiologic cultures were done just prior to initiation of treatment and again on days 3 and 7. Statistical analysis revealed a sigicant improvement in the clinical signs, bacterial count, cure rate, and improvement rate for subjec takidng the active medication, compared with those taking the placebo on days 3 and 7. In addition, the medication was well tolerated.Mercuric oxide (yellow) is an antibacterial agent which has been incorporated into an ointment base for ophthalmic use in the treatment of common minor eyelid infections. It has been available in this form without prescription for over 30 years. It is antibacterial by its ability to reversibly inhibit bacterial sulfhydryl enzymes (5). Side effects, other than minor local irritation experienced by some individuals upon initial application, are rare with short-term use. Reports of local hypersensitivity reactions resulting in reversible blepharitis and conjunctivitis have also been rare (10). Rarely, continuous long-term use has resulted in bluish gray discoloration of the eyelids, conjunctiva, and peripheral cornea, without irritation or disturbance of visual acuity (20).Bacterial blepharitis is a common minor infection of the eyelid margin and is an indication for treatment with an antibacterial agent such as mercuric oxide. The safety and efficacy of 1% mercuric oxide ophthalmic ointment in the treatment of minor eyelid infections have been addressed in one report in the literature (9). That study concluded that the medication was safe and effective in reducing the number of bacteria in subjects with blepharitis or styes. This study was designed to assess the effects of 1% yellow mercuric oxide ophthalmic ointment on clinical signs and symptoms of blepharitis as well as the safety and quantitative microbiologic efficacy of the ointment. MATERLALS AND METHODSPreliminary study. A preliminary study was done to assess the number and type of bacteria present as normal base-line flora of the eyelid margin in this geographic area. The purpose of this study was to establish guidelines for what would be quantitatively considered microbiologically abnormal. These guidelines would improve the sensitivity of the study for detecting a treatment effect, if one existed. Any inadequacy of these guidelines would result in less of a difference in the response rate between the treatment and control groups. Cultures of the lower eyelid margin were taken from both eyes of 10 subjects who were determined by biomicroscopy to be free of eyelid infection. The culture and processing techniques are described below. From the preliminary study we deriv...

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Etiology and Treatment of Blepharitis

Cited by 47 publications

References 17 publications

Bloody tears: a case of bilateral ulcerative blepharitis

Bloody tears: a case of bilateral ulcerative blepharitis

Periodic acid–Schiff staining demonstrates fungi in chronic anterior blepharitis

Efficacy and safety of mercuric oxide in the treatment of bacterial blepharitis

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