Blepharitis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]

Overview

Physical examination of patients with blepharitis is usually remarkable for irritated eyelid edges, hard crusting of the lashes, entropion, ectropion, poliosis, and diffuse conjunctival injection.^[1]^[2]

Physical Examination

Common skin examination findings of blepharitis include:^[1]^[2]^[3]

Scalp or facial skin itching and flaking (suggestive of seborrheic dermatitis)
Facial flushing and Telangiectasia on cheeks and nose (suggestive of acne rosacea)

Common eye examination findings of blepharitis include:^[2]^[4]^[5]

Pink or irritated eyelid edges
Hard crusting of the lashes (staphylococcal blepharitis)
Greasy appearing flakes (seborrheic blepharitis)
Cylindrical dandruff on the base of lashes (suggestive of Demodex folliculorum infestation)
Telangiectasia on the anterior eyelid
Entropion
Ectropion
Trichiasis
Madarosis
Poliosis
Distichiasis
Diffuse conjunctival injection

On slit lamp examination, blepharitis is characterized by:

Images

The following are images associated with blepharitis:^[6]

Entropion and trichiasis – By Otis Historical Archives Nat’l Museum of Health & Medicine – originally posted to Flickr as A44-652-11, CC BY 2.0, https://commons.wikimedia.org/w/index.php?curid=6215100

References

↑ ^1.0 ^1.1 Dougherty JM, McCulley JP (1986). “Bacterial lipases and chronic blepharitis”. Invest Ophthalmol Vis Sci. 27 (4): 486–91. PMID 3957566.
↑ ^2.0 ^2.1 ^2.2 THYGESON P, VAUGHAN DG (1954). “Seborrheic blepharitis”. Trans Am Ophthalmol Soc. 52: 173–88. PMC 1312591. PMID 13274422.
↑ Lemp MA, Nichols KK (2009). “Blepharitis in the United States 2009: a survey-based perspective on prevalence and treatment”. Ocul Surf. 7 (2 Suppl): S1–S14. PMID 19383269.
↑ Blepharitis. American Academy of Ophthalmology/eyewiki (2014). http://eyewiki.org/Blepharitis Accessed on July 14, 2016
↑ Blepharitis. National Eye Institute. (2009). https://nei.nih.gov/health/blepharitis/blepharitis Accessed on July, 14, 2016
↑ Tomlinson A, Bron AJ, Korb DR, Amano S, Paugh JR, Pearce EI; et al. (2011). “The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee”. Invest Ophthalmol Vis Sci. 52 (4): 2006–49. doi:10.1167/iovs.10-6997f. PMC 3072162. PMID 21450918.

Overview