Blepharitis Signs and Symptoms

• Blepharitis may have periods of exacerbations and remissions
• Usually occurs in middle-aged adults but can also start in childhood
• Can affect vision by disrupting the surface of the cornea and the bulbar conjunctiva; may influence tear film composition

• An inflammatory process affecting the eyelid margins, eyelash follicles, or openings of the anteriorly-placed accessory lacrimal glands and the posteriorly-placed meibomian glands that causes ocular irritation and redness acutely but usually chronically

Associated Conditions

• Ocular conditions
  
  • Keratoconjunctivitis sicca may cause alteration in bacteria resistance brought about by the decrease in local lysozyme and immunoglobulin levels
  • Hordeolum/stye is an acute infection of the oil gland of the eyelid that causes abnormal secretions that block the glands which may secondarily infected
  • Chalazion is a firm non-tender bump in the eyelid caused by granulomatous inflammatory reaction of the meibomian gland
  • Dry eye may result from abnormal or decreased meibomian gland secretions
  • Contact lens intolerance or discomfort due to alteration in the lipid layer of the tear film
    • Patients with contact lens-associated giant papillary conjunctivitis (GPC) have higher frequency of meibomian gland dysfunction (MGD)

• Dermatological diseases
  
  • Rosacea is associated with epithelial basement membrane abnormalities and recurrent corneal epithelial erosions
  • Seborrheic dermatitis has been found in most patients with seborrheic blepharitis

• Demodex folliculorum
  
  • Recalcitrant blepharitis has responded to treatment directed at Demodex mites eradication 

• Isotretinoin
  
  • Oral medication for severe cystic acne
  • Causes an increase colonization of the conjunctiva with Staphylococcus aureus and disruption in tear function predisposing to the development of staphylococcal blepharitis