Itching, burning, mild pain, foreign body sensation, tearing, erythema of the eyelids, and crusting around the eyes upon awakening. This is in contrast to dry eye syndrome in which symptoms are usually worse later in the day.
Critical
Crusty, red, thickened eyelid margins with prominent blood vessels (see Figure 5.8.1) or inspissated oil glands at the eyelid margins (see Figure 5.8.2). Crusting, collarettes, and/or cylindrical sleeves around lashes.
5-8.2 Meibomitis with inspissated meibomian glands.
Other
Conjunctival injection, swollen eyelids, mild mucous discharge, and SPK. Rosacea may be present. Corneal infiltrates, pannus, and phlyctenules may be present.
See 5.9, OCULAR ROSACEA, for treatment options in the presence of acne rosacea.
NOTE: |
Tetracycline derivatives such as doxycycline should not be used in pregnant women, nursing mothers, or children ≤8 years. Erythromycin 200 mg p.o. b.i.d. is an alternative in these cases. |
Two to four weeks depending on the severity of presenting symptoms. Eyelid scrubs and warm compresses may be reduced to once daily as the condition improves but may need to be maintained indefinitely.
NOTE: |
Intractable, unilateral, or asymmetric (not only of eye laterality but also upper versus lower eyelid) blepharitis is rarely a manifestation of sebaceous carcinoma of the eyelid and warrants appropriate clinical workup. See 6.11, MALIGNANT TUMORS OF THE EYELID. |