Blepharitis is a chronic lid inflammation that involves abnormalities of the glands surrounding the eyelashes. The two most common types are chronic staphylococcal infections of the lid and seborrheic blepharitis (Fig. 41-6). Staphylococcal blepharitis is the most common inflammation of the external eye. It is frequently asymptomatic initially, but as the disease progresses, the patient complains of foreign body sensation, matting of the lashes, and burning. Lid crusting, discharge, redness, and loss of lashes are observed. Seborrheic blepharitis is associated with seborrhea of the scalp, lashes, eyebrows, and ears, characterized by greasy, dandruff-like scales on the lashes. Blepharitis is not associated with skin ulcerations.

Figure 41-8 Chalazion of right upper eyelid in 10-year-old girl. (FromAAO. The Red Eye.)

Treatment of both these conditions is long and laborious. Lid hygiene is recommended for both conditions. Topical antibiotics are prescribed for staphylococcal blepharitis. Both conditions are recurrent and require repeated therapy.

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