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Blepharitis — Overview, Symptoms, Treatments, and Other Resources.
Blepharitis (also known as Granulated Eyelids)
Comprehensive Guides
What is blepharitis, what are its symptoms, and how is it treated? Information from the National Eye Institute
Blepharitis is a common condition that causes inflammation of the eyelids. The condition can be difficult to manage because it tends to recur. Blepharitis occurs in two forms: Anterior blepharitis affects the outside front of the eyelid, where the eyelashes are attached. The two most common causes of anterior blepharitis are bacteria (Staphylococcus) and scalp dandruff. Posterior blepharitis affects the inner eyelid (the moist part that makes contact with the eye) and is caused by problems with the oil (meibomian) glands in this part of the eyelid. Two skin disorders can cause this form of blepharitis: acne rosacea, which leads to red and inflamed skin, and scalp dandruff (seborrheic dermatitis)....more from National Eye Institute, National Institutes of Health.

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Information on Blepharitis from the National Library of Medicine
Blepharitis is usually caused by seborrheic dermatitis or a bacterial infection, and sometimes it is a combination of both. Allergies and eyelash infestation with lice may also cause blepharitis, although these causes are less common. This condition is characterized by excess oil production in the glands near the eyelid. Too much oil creates an environment where the normal bacteria found on the skin can overgrow. The eyelids appear red and irritated, with scales that cling to the base of the eyelashes. Blepharitis may be connected to repeated styes and chalazia. Risk factors are seborrheic dermatitis of the face or scalp, rosacea, lice, and allergies...more from Medline Plus, U.S. National Library of Medicine and the National Institutes of Health.

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Mayo Clinic on Blepharitis
Blepharitis at MayoClinic.com.

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Videos and Podcasts
Video Video: Meibomian gland dysfunction causing blepharitis
When the meibomian glands clog up, the oil gets thick and can cause surface irritation. Watch this video at RootAtlas website sponsored by the Eye Teachers of America Foundation.

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Video Video: Proper Lid Cleaning
Lid cleaning with a cotton bud soaked in sterile water; this is the main treatment for blepharitis. Watch the video at the NHS Goodhope Eye Dept. website UK.

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Clinical Practice Guidelines
What treatments are helpful for blepharitis?
There is insufficient evidence to make definitive recommendations for the treatment of blepharitis (Miller et al., 2005) and the patient must understand that a cure is not possible in most cases. Treatments that are helpful include the following: Warm compresses, Eyelid hygiene, Antibiotics (topical and/or systemic), and Topical anti-inflammatory agents (e.g., corticosteroids, cyclosporine). See National Guideline Clearinghouse major recommendations.

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Important Articles from Medical Journals
Abstract: Blepharitis: current strategies for diagnosis and management.
BACKGROUND: The aim of this article is to present a consensus on the appropriate identification and management of patients with blepharitis based on expert clinical recommendations for 4 representative case studies and evidence from well-designed clinical trials. METHODS: The case study recommendations were developed at a consensus panel meeting of Canadian ophthalmologists and a guest ophthalmologist from the U.K., with additional input from family doctors and an infectious disease/medical microbiologist, which took place in Toronto in June 2006. A MEDLINE search was also conducted of English language articles describing randomized controlled clinical trials that involved patients with blepharitis. Full text available free through PubMed.

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Abstract: Differential diagnosis of the swollen red eyelid.
The differential diagnosis of eyelid erythema and edema is broad, ranging from benign, self-limiting dermatoses to malignant tumors and vision-threatening infections. A definitive diagnosis usually can be made on physical examination of the eyelid and a careful evaluation of symptoms and exposures. Full text available free through PubMed.

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Abstract: Chronic blepharitis. Pathogenesis, clinical features, and therapy.
Chronic blepharitis is one of the most common diseases of the eyelids, but surprisingly, it is not often recognized. Frequently, a skin disease such as seborrheic dermatitis, atopic dermatitis, or acne rosacea is the underlying cause of chronic blepharitis. See Abstract at PubMed.

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Abstract: Demodex folliculorum and Demodex brevis as a cause of chronic marginal blepharitis.
INTRODUCTION: Intensive long-term studies of Demodex spp. (D.) and its role in chronic blepharits have been carried out in recent years by scientists from the Pomeranian Medical University in Szczecin. It has resulted in numerous publications, spurring a lot of interest worldwide. A few of the papers have been cited in leading American medical journals. In recent years many papers dealing with demodicosis of the eyelids have been published worldwide. Based on the growing interest in the role of Demodex spp. in chronic blepharitis we decided to present and discuss the results of the latest experimental and clinical studies. MATERIAL AND METHODS: A review of the literature concerning the role of D. folliculorum and D. brevis in the pathogenesis of chronic blepharitis was done. See Abstract at PubMed.

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Abstract: Dry eye, blepharitis and chronic eye irritation: divide and conquer.
Dry eye and posterior blepharitis are the two most common causes for chronic eye irritation. Dry eye is caused by loss of water from the tear film resulting from either decreased tear production or increased tear film evaporation. The resultant increase in tear film osmolarity causes the changes on the eye surface responsible for the symptoms of dry eye. Posterior blepharitis causes eye irritation from inflammation, and leads to the development of meibomian gland dysfunction. See Abstract at PubMed.

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Abstract: Prevalence and treatment of Helicobacter pylori in patients with blepharitis.
PURPOSE: Helicobacter pylori is a major pathogen etiologically associated with gastritis, peptic ulcer disease, gastric cancer, and primary gastric lymphoma. This study was conducted to investigate a possible association between Helicobacter pylori infection and blepharitis. Full text available free through PubMed.

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Abstract: Comparative bacteriology of chronic blepharitis.
One hundred and fifteen patients with chronic blepharitis were compared with 47 normal controls. Six clinically distinct groups of blepharitis were observed: staphylococcal; seborrhoeic, alone, with associated staphylococcal superinfection, meibomian seborrhoea, or secondary inflammation of the meibomian glands; and meibomian keratoconjunctivitis (MKC). Full text available free through PubMed.

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Abstract: The role of tetracycline in chronic blepharitis. Inhibition of lipase production in staphylococci.
Tetracycline administered in low doses can be effective in the long-term management of patients with meibomian keratoconjunctivitis (MKC). However, the mechanism of action does not appear to be a reduction of bacteria. Seventy-five percent of the ocular staphylococci in such patients are resistant to tetracycline. An alternative mechanism of action could be the inhibition of production of extracellular enzymes by the ocular flora. Full text available free through PubMed.

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Eyelid Cleaning (click for a short video)
Source: Good Hope U.K. NHS

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