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A seg > Blepharitis > Flashcards

Blepharitis Flashcards

1
Q

Anterior Blepharitis

  • What is it?
  • Caused by what
A

Chronic inflammation of the eyelid margin anterior to the mucocutaenous junction.

Stephylococcal- can create biofilm that can migrate into the lash follicle and cause low grade inflammation.
Seborrheic- excessive sebum released by sebaceous glands.

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2
Q

Anterior Blepharitis

Demographics and laterality

A

Common in adults

Bilateral

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3
Q

Anterior Blepharitis
Symptoms
signs

A

Symptoms: Crusty debris along the eyelid margins, margin redness, ocular irritation and tearing.

Signs: Flakes within eyelashes and on skin around. If seborrheic, will look greasy.
Eyelid margin red and edema
Madarosis
Tear film debris

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4
Q

Anterior Blepharitis management

A

Eyelid cleanser.

Hypochlorous acid eyelid spray to neutralize bacteria, toxins, and inflammatory mediators

Warm compress to soften crusty debris

Antibiotic or antibiotic steroid combo ung for moderate-severe

BlephEx in office

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5
Q

Demodicosis

  • What is it
  • What causes it
A

Specific type of anterior blepharitis due to Demodex infestation.
Common parasite that resides near pilosebaceous units.

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6
Q

Demodicosis

Demographics and laterality

A

Elderly

Bilateral

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7
Q

Demodicosis
Symptoms
Signs

A

Symptoms- Eyelid margin itchy in the morning. Crusty debris along the eyelid margins. Margin redness. Ocular irritation and tearing.

Signs- Cylindrical dandruff at the base. Mite attached at base. Epilate lash and view under microscope. Margin is red and edema. Madarosis. Tear film debris.

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8
Q

Demodicosis management

A 
Eyelid cleanser with tea tree oil BIDx 1 month. 
Bleph Ex (first application kills adults) then RTC in 2 weeks for another application to kill eggs. Antiobiotic/steroid ung following.

Discard old makeup and discontinue for 1 month

Spouse/partner eval.

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9
Q

Active ingredient in tea tree oil that kills remodel mites

A

4 terpineol

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10
Q

Don’t use 100% tea tree oil. Dilute to ___

A

20-50%

Best option is to buy commercially available eyelid cleanser with tea tree oil.

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11
Q

Posterior Bleph/MGD/Meibomitis

  • What is it
  • What causes it
A

Chronic inflammation of the eyelid margin posterior to the mucocutaneous junction.

Inflammatory reaction to a colony of bacteria on the eyelid margin (biofilm) Causes thickening and stasis of meibum. Maybe associated with acne rosacea.

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12
Q

Posterior Bleph/MGD/Meibomitis

Demographics and laterality

A

Adults

Bilateral

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13
Q

Posterior Bleph/MGD/Meibomitis

Symptoms and signs

A

Symptoms
Eyelid margin redness. Ocular irritation, tearing.

Signs
Eyelid margin erythema and edema, meibomian gland capping, turbid expression of MG, telangiectasia, MG atrophy, decreased TBUT, Tear film debris.

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14
Q

Posterior Bleph/MGD/Meibomitis

Management

A

Eyelid cleanser

Hypochlorus spray to neutralize

Warm compress to liquefy meibum

Topical lubrication with lipid eye drops

Omega 3 fatty acid supplement to improve meibum production.

Oral doxycycline if bleph is causing.

Moderate-severe use antibiotic or combo ung

Bleph Ex

meibomian gland expression in office

Meibomian gland probing in office

Lipiflow in office- acts as powerful warm compress to liquefy the meibum secretions.

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15
Q

Primary cause of evaporative dry eye

A

Posterior Bleph/MGD/Meibomitis

85% of dry eye cases have MGD as its primary or contributory cause

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16
Q

Posterior Bleph/MGD/Meibomitis frequently occurs in conjunction with

A

Anterior blepharitis

17
Q

Angular blepharitis
-What is it
What causes it

A

Infection of the EPIDERMIS at the temporal cants
Caused by staph aureus or moraxella lacuna (Stickier, frothier presentation)
Less commonly herpes simplex

18
Q

Angular blepharitis

Demographics and laterality

A

More common in adults

Unilateral

19
Q

Angular blepharitis

Symptoms and signs

A

Symptoms- Red, crusting, white discharge at temporal canthus.

Signs- Erythema, crusting, white frothy discharge at the temporal canthus. Fissured skin at temporal canthus.

moraxella lacuna (Stickier, frothier presentation)

20
Q 
moraxella lacuna (Stickier, frothier presentation)
Management
A

Eyelid cleanser

Hypochorous acid spray to neutralize

Antibiotic or combo ung

A seg (33 decks)

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