Blepharitis Overview and Symptoms

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Questions and Answers

What symptom is commonly associated with blepharitis?

Burning sensation in the eyes (correct)

Significant swelling of the eyelids

Yellow discharge

Chronic visual loss

Which condition can present similarly to blepharitis?

Glaucoma

Stye (correct)

Contact lens irritation

Retinal detachment

What are the appropriate initial treatment methods for blepharitis?

Antibiotic eye drops and warm compresses

Warm compresses and eyelid scrubbing (correct)

Cold compresses and topical steroids

Surgical intervention and topical antihistamines

Which type of blepharitis is associated with pustules at the base of hair follicles?

Staphylococcal blepharitis Signup and view all the answers

What is the role of eyelid and conjunctival cultures in diagnosing blepharitis?

They are usually unnecessary. Signup and view all the answers

When managing posterior blepharitis, what treatment may be recommended if conservative measures fail?

Topical fluoroquinolone or bacitracin Signup and view all the answers

What kind of discharge may indicate a problem with the meibomian gland during an eyelid examination?

White sebaceous discharge Signup and view all the answers

Which of the following is a common complaint associated with blepharitis?

Foreign body sensation Signup and view all the answers

What is a distinguishing characteristic of a hordeolum compared to a chalazion?

It is tender and erythematous. Signup and view all the answers

Which treatment is considered the mainstay for both hordeolum and chalazion?

Warm compresses and eyelid scrubbing. Signup and view all the answers

Which condition is marked by a painless swelling of the eyelid?

Chalazion. Signup and view all the answers

When should a referral to an ophthalmologist be considered for a hordeolum?

If it becomes persistent or resistant to treatment. Signup and view all the answers

What is the typical method for diagnosing hordeolum and chalazion?

Patient history and appearance. Signup and view all the answers

What symptom is indicative of a potential orbital cellulitis that warrants urgent referral?

Pain with eye movement. Signup and view all the answers

Which is an appropriate topical medication for a hordeolum?

Erythromycin ointment. Signup and view all the answers

Blepharitis could potentially be confused with which other condition?

Hordeolum. Signup and view all the answers

Study Notes

Blepharitis

Inflammation of eyelids and margins
Two types: anterior and posterior
Anterior: affects eyelash follicles
Posterior: obstruction of meibomian glands
Symptoms: itching, burning, tearing, redness, foreign body sensation
Symptoms can be unilateral or bilateral
Symptoms tend to be worse in the morning
Physical exam: lid margins are edematous and erythematous
May reveal scaling, erythema, crusting, scale fragments along lid margins
Palpating eyelid and lid margins may reveal masses
Gentle pressure on eyelid may reveal white sebaceous discharge from meibomian gland
Staphylococcus blepharitis: pustules at the base of hair follicles may crust or bleed
Severe blepharitis can be associated with rosacea
Diagnostics: evaluate visual acuity bilaterally, eyelid and conjunctival cultures not usually needed
Differentials: persistent inflammation and thickening of eyelid margin, squamous cell, basal cell, sebaceous cell carcinoma, hordeolum, conjunctivitis, herpes simplex infection, orbital cellulitis, dacryocystitis, foreign body
Treatment: warm compresses, gentle eyelid scrubbing at base of lashes
Staphylococcal blepharitis: bacitracin or erythromycin 0.5% ointment 1-3 times/day for 7-10 days
Posterior blepharitis: compresses/massage to Meibomian gland, topical fluoroquinolone or bacitracin, oral doxycycline
Severe blepharitis: oral doxycycline 100mg 2x/day, tetracycline 250mg 4x/day, or refer to ophthalmologist
Patient education: wash hands often, avoid irritants, hypoallergenic soap and makeup, careful with contact lenses, long-term eyelid hygiene for recurrent blepharitis

Hordeolum and Chalazion

Both caused by ductal obstruction of meibomian gland, often secondary staphylococcus infection
Hordeolum (Stye): acute, erythematous eyelid lump caused by inflammation or infection of the eyelid margin
Presents as tender, erythematous lump localized to eyelid affecting hair follicles of eyelash or meibomian glands
Chalazion: granulomatous inflammation due to glandular blockage (meibomian gland)
Presents as non-tender lump/painless swelling of the eyelid, may initially be tender and erythematous, slow developing, high recurrence
Physical exam: evaluate visual acuity (typically unaffected)
Hordeolum: erythema, localized tenderness with palpation, drainage from the lesion, pustule
Chalazion: inversion of eyelid reveals red, elevated, painless mass
Pain with eye movement and eyelid edema, erythema should raise concern for orbital cellulitis → urgent referral
Diagnostics: usually diagnosed by appearance, cultures not indicated for uncomplicated/first-time occurrences
Differentials: persistent inflammation and thickening of eyelid margin, squamous cell, basal cell, sebaceous cell carcinoma, blepharitis, conjunctivitis, herpes simplex infection, orbital cellulitis, dacryocystitis, foreign body
Treatment: warm compresses, gentle eyelid scrubbing followed by gentle massage
Hordeolum infection/inflammation: erythromycin ointment, sulfacetamide ointment 4x/day, or ciprofloxacin ointment 3x/day to eyelid margin
Hordeolum resistant/recurrent: oral doxycycline, refer to ophthalmologist
Chalazion: warm compresses, gentle eyelid scrubbing followed by gentle massage
Chalazion resistant/recurrent: intralesional corticosteroid injection, surgical excision
Chalazion may resolve spontaneously
Chalazion treatment goal is to reduce inflammation and prevent recurrence

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Description

This quiz covers the key aspects of blepharitis, including its types, symptoms, and examination findings. Understand the causes and associated conditions, as well as important diagnostic features to recognize. Perfect for students and healthcare professionals alike.