Term that encompasses various conditions which cause chronic inflammation of the eyelid margins

Aetiology

• Usually develops in middle-age but may occur at any age

Anterior blepharitis

• Refers to inflammation of the base of the eyelashes (located on the anterior margin of the eyelid)
• It can be caused by:
  • Bacteria (usually staphylococci) - staphylococcal blepharitis
  • Seborrhoeic dermatitis - seborrhoeic blepharitis
    • Characterized by less inflammation than staphylococcal blepharitis; however, it causes more excess oil or greasy scaling

Posterior blepharitis

• Inflammation of the meibomian glands (often called meibomian gland dysfunction)
• The meibomian glands are a set of glands that run along the posterior eyelid margin
• They produce a lipid secretion which provides the lipid layer of the tear film

Clinical presentation

Symptoms

• Burning, itching and/or crusting of the eyelids
• Symptoms are worse in the mornings
• Both eyes are affected
• Recurrent hordeolum
• Contact lens intolerance

Signs

• Anterior blepharitis - lid margin redder than deeper part of lid
• Posterior blepharitis - redness is in deeper part of lid, lid margin often looks normal