Operational Medicine 2001
Blepharitis

Definition:  The most common inflammation of the eyelids.  It usually involves the lid margins and frequently is associated with conjunctivitis.

Signs/Symptoms:  

• Foreign-body sensation

• Tearing

• Itching

• Burning

• Crusting around the eyes

• Punctate staining with fluorsceine

• Lid swelling

• Mild discharge

Differential Diagnosis:  

• Meibomianitis

• Dry eye syndrome

Causes:   Bacterial infection by staphylococcus is frequently responsible

Evaluation:

• Visual acuity

• Anterior segment evaluation

• Evaluation of the eye lids for crusting on the lashes

• Notches in the lid margin indicative of chronic disease

• White eyelashes indicative of chronicity

• Thickened eyelid margins with prominent blood vessels

• Evaluate the cornea for marginal scarring and blood vessels  

Treatment:

• Scrub the eyelid margins with mild shampoo (Johnson’s baby shampoo) twice a day

• Warm compresses for 20 minutes two to 4 times a day on the eyes

• Artificial tears 4 to 6 times a day

• Erythromycin ointment at bedtime

• If severe or recurrent then use tetracycline 250mg po qid for 14 days

Prognosis: 

• Generally good

• Should not interfere with daily routine of duty.  

• After instillation of ointment wait ½ hour before operating machinery as ointment may make vision blurry.

This section provided by CAPT Robert B. North, Jr., MC, USN

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Operational Medicine 2001
Health Care in Military Settings

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