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Blepharitis: Overview and Classification
Key Concepts
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Blepharitis is a common but often overlooked disease with the potential to significantly alter quality of life.
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Blepharitis can be due to acute infection by bacteria, viruses, and parasites, or as a function of primary skin/lid disease.
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Modern classification categorizes blepharitis anatomically, as anterior or posterior with the gray line as the anatomic landmark, or clinically, as being secondary to infection, inflammation, or meibomian gland disease.
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Blepharitis treatment may involve four fundamental arms: improvement of the local lid environment, topical antibiotics, systemic antibiotics, and corticosteroids or other immunomodulators.
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Newer treatment modalities have been developed to target anterior or posterior disease.
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Understanding the classification of the disease will help to determine which treatment modalities should be chosen or emphasized.
Blepharitis, or eyelid margin inflammation, is one of the most common disorders encountered in ophthalmology. It is estimated that eye care specialists see blepharitis in up to 47% of their patients. Despite its prevalence, blepharitis is often overlooked and misdiagnosed, in part due to symptoms often being vague and varied. It can be extremely debilitating for patients, occasionally resulting in limitations in daily activities and a loss in quality of life. Furthermore, it can be source of immense frustration for both the ophthalmologist and patient because it can often prove difficult to treat, due to its chronicity and underlying or associated conditions. Although the lids may be the source of the primary inflammatory process, involvement of the cornea and bulbar conjunctival surfaces produces the most important and significant symptoms and visual consequences for the patient. Understanding the classification of blepharitis will help one to understand the rationale for the various treatment modalities.
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