Practice 10-Minute Consultation

Blepharitis

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e3328 (Published 23 May 2012) Cite this as: BMJ 2012;344:e3328
  1. Andrew M J Turnbull, ophthalmic specialist trainee1,
  2. Martin P Mayfield, sessional general practitioner2
  1. 1Bournemouth Eye Unit, Bournemouth BH7 7DW, UK
  2. 2Harrogate, UK
  1. Correspondence to: A M J Turnbull andyt{at}doctors.org.uk
  • Accepted 22 February 2012

A 57 year old man presents with persistently sore, irritated eyes and describes a burning, gritty sensation and intermittently blurred vision. His eyes occasionally water but there is no discharge. He has used over the counter chloramphenicol drops and was prescribed a course of fusidic acid drops, each time with only temporary benefit. He is fed up with the discomfort. On examination, his eyelids appear red with scaly crusts around the eyelashes. There is mild, diffuse conjunctival injection, and yellowish “plugs” (swellings) are present along the posterior margin of the eyelid. Pupil reactions and eye movements are normal, and there is no evidence of visual disturbance.

Blepharitis means inflammation of the eyelids. Anterior blepharitis affects the outer margins of the eyelids (where the eyelashes emerge); posterior blepharitis affects the inner margins (which touch the eye). Anterior blepharitis is generally of staphylococcal or seborrhoeic origin, and posterior blepharitis results from meibomian gland dysfunction. Mixed blepharitis (combining anterior and posterior components) is common and was the diagnosis in this patient.

Staphylococcal blepharitis is …

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