Blepharitis

Publication Date: February 11, 2024
Last Updated: February 16, 2024

HIGHLIGHTED FINDINGS AND RECOMMENDATIONS FOR CARE

In the management of ocular surface disease, it is helpful to distinguish anterior and posterior (meibomian gland dysfunction [MGD]) blepharitis from aqueous deficient dry eye. Anterior blepharitis affects the lash line and includes posterior blepharitis, which is defined as meibomian gland involvement. Worsening of symptoms in the morning is typical of blepharitis, whereas worsening of the symptoms later in the day are typical of aqueous deficient dry eye. (, , )
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Blepharitis is typically a chronic condition that cannot be permanently cured. It is important for patients to understand that successful management depends on their compliance with a treatment regimen. (, , )
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Topical antibiotic drops or ointments with or without corticosteroids and/or oral antibiotics can be effective in the treatment of blepharitis. Although azithromycin is used as a treatment for blepharitis, it may produce cardiac arrhythmias when used orally in patients with cardiovascular problems. (, , )
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In-office procedures targeting the meibomian glands have shown efficacy in some studies, but there is a lack of independent, randomized controlled studies demonstrating superiority of any one of these treatments over another. (, , )
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In patients with blepharitis who do not respond to therapy, the possibility of carcinoma or immune-mediated diseases should be considered, particularly if the blepharitis is associated with loss of eyelashes and/or conjunctival cicatricial changes. Early diagnosis and appropriate treatment can prevent vision loss and disfigurement, and it may be lifesaving. (, , )
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Recommendation Grading

Overview

Title

Blepharitis

Authoring Organization

Publication Month/Year

February 11, 2024

Last Updated Month/Year

February 19, 2024

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

Establish the diagnosis of blepharitis, differentiating it from other causes of irritation and redness. Identify the type of blepharitis. Establish appropriate therapy. Relieve discomfort and pain. Prevent complications. Educate and engage the patient in the management of this potentially chronic disease
 

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Older adult

Health Care Settings

Ambulatory, Emergency care, Outpatient

Intended Users

Optometrist, nurse, nurse practitioner, physician, physician assistant

Scope

Diagnosis, Management, Treatment

Diseases/Conditions (MeSH)

D001762 - Blepharitis, D005141 - Eyelid Diseases

Keywords

blepharitis, eye inflammation, eyelid swelling

Source Citation

Lin A, Ahmad S, Amescua G, Cheung AY, Choi DS, Jhanji V, Mian SI, Rhee MK, Viriya ET, Mah FS, Varu DM; American Academy of Ophthalmology Preferred Practice Pattern Cornea/External Disease Panel. Blepharitis Preferred Practice Pattern®. Ophthalmology. 2024 Feb 12:S0161-6420(24)00008-3. doi: 10.1016/j.ophtha.2023.12.036. Epub ahead of print. PMID: 38349296.

Supplemental Methodology Resources

Data Supplement

Methodology

Number of Source Documents
160
Literature Search Start Date
March 3, 2022
Literature Search End Date
June 7, 2023