Blepharitis physical examination: Difference between revisions

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{{Blepharitis}}
{{Blepharitis}}
{{CMG}} {{AE}} {{SaraM}}
{{CMG}}; {{AE}} {{SaraM}}


==Overview==
==Overview==
Physical examination of patients with blepharitis is usually remarkable for irritated eyelid edges, hard crusting of the lashes or greasy appearing flake, [[entropion]], [[ectropion]], [[poliosis]], and diffuse [[conjunctival injection]].
Physical examination of patients with blepharitis is usually remarkable for irritated eyelid edges, hard crusting of the lashes, [[entropion]], [[ectropion]], [[poliosis]], and diffuse [[conjunctival injection]].<ref name="pmid3957566">{{cite journal| author=Dougherty JM, McCulley JP| title=Bacterial lipases and chronic blepharitis. | journal=Invest Ophthalmol Vis Sci | year= 1986 | volume= 27 | issue= 4 | pages= 486-91 | pmid=3957566 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3957566  }} </ref><ref name="pmid13274422">{{cite journal| author=THYGESON P, VAUGHAN DG| title=Seborrheic blepharitis. | journal=Trans Am Ophthalmol Soc | year= 1954 | volume= 52 | issue=  | pages= 173-88 | pmid=13274422 | doi= | pmc=1312591 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13274422  }} </ref>


==Physical Examination==
==Physical Examination==
===Facial and Scalp Examination===
===Skin===
Facial and scalp examination of patients with blepharitis is usually remarkable for:
Common skin examination findings of blepharitis include:<ref name="pmid3957566">{{cite journal| author=Dougherty JM, McCulley JP| title=Bacterial lipases and chronic blepharitis. | journal=Invest Ophthalmol Vis Sci | year= 1986 | volume= 27 | issue= 4 | pages= 486-91 | pmid=3957566 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3957566  }} </ref><ref name="pmid13274422">{{cite journal| author=THYGESON P, VAUGHAN DG| title=Seborrheic blepharitis. | journal=Trans Am Ophthalmol Soc | year= 1954 | volume= 52 | issue=  | pages= 173-88 | pmid=13274422 | doi= | pmc=1312591 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13274422  }} </ref><ref name="pmid19383269">{{cite journal| author=Lemp MA, Nichols KK| title=Blepharitis in the United States 2009: a survey-based perspective on prevalence and treatment. | journal=Ocul Surf | year= 2009 | volume= 7 | issue= 2 Suppl | pages= S1-S14 | pmid=19383269 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19383269  }} </ref>
*Itching and flaking scalp or facial skin ([[seborrheic dermatitis]])
*Scalp or facial skin itching and flaking (suggestive of [[seborrheic dermatitis]])
*Facial flushing ([[acne rosacea]])
*Facial flushing and [[Telangiectasia]] on cheeks and nose (suggestive of [[acne rosacea]])
*Broken or swollen blood vessels on cheeks and nose, and red or swollen nose ([[acne rosacea]])
 
===Eye Examination===
===Eye===
Eye examination of patients with blepharitis is usually remarkable for:
 
====Gross Eye Examination====
Common eye examination findings of blepharitis include:<ref name="pmid13274422">{{cite journal| author=THYGESON P, VAUGHAN DG| title=Seborrheic blepharitis. | journal=Trans Am Ophthalmol Soc | year= 1954 | volume= 52 | issue=  | pages= 173-88 | pmid=13274422 | doi= | pmc=1312591 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13274422  }} </ref><ref name=Blepharitis-1> Blepharitis. American Academy of Ophthalmology/eyewiki (2014). http://eyewiki.org/Blepharitis Accessed on July 14, 2016 </ref><ref name=Blepharitis-3> Blepharitis. National Eye Institute. (2009). https://nei.nih.gov/health/blepharitis/blepharitis Accessed on July, 14, 2016 </ref>
*Pink or irritated eyelid edges
*Pink or irritated eyelid edges
*Hard crusting of the lashes (staphylococcal blepharitis)
*Hard crusting of the lashes (staphylococcal blepharitis)
*Greasy appearing flake (seborrheic blepharitis)
*Greasy appearing flakes (seborrheic blepharitis)
*Cylindrical [[dandruff]] covers base of lash (Demodex)
*Cylindrical dandruff on the base of lashes (suggestive of ''[[Demodex folliculorum]]'' infestation)
*[[Telangiectasia]] on the anterior eyelid
*[[Telangiectasia]] on the anterior eyelid
*[[Entropion]]  
*[[Entropion]]  
*[[Ectropion]]
*[[Ectropion]]
*[[Trichiasis]]  
*[[Trichiasis]]  
*Madarosis(loss of lashes)
*Madarosis
*[[Poliosis]] (loss of pigmentation of lashes)
*[[Poliosis]]  
*Distichiasis (abnormal growth of eyelashes)
*Distichiasis  
*Diffuse [[conjunctival injection]]
*Diffuse [[conjunctival injection]]
====Slit Lamp Examination====
On [[slit lamp|slit lamp examination]], blepharitis is characterized by:
*[[Meibomian gland|Meibomian gland enlargement]]
*Waxy secretions at the gland openings
*Lid margin [[neovascularization]] and dilation of existing blood vessels
*[[Ulcerations]] along the eyelid margin
*Corneal nodules
*Corneal margin ulcer
*Superficial corneal pannus
==Images==
The following are images associated with blepharitis:<ref name="pmid21450918">{{cite journal| author=Tomlinson A, Bron AJ, Korb DR, Amano S, Paugh JR, Pearce EI et al.| title=The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee. | journal=Invest Ophthalmol Vis Sci | year= 2011 | volume= 52 | issue= 4 | pages= 2006-49 | pmid=21450918 | doi=10.1167/iovs.10-6997f | pmc=3072162 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21450918  }} </ref>
<gallery>
Image:Entropion.jpeg|Entropion and trichiasis - By Otis Historical Archives Nat'l Museum of Health & Medicine - originally posted to Flickr as A44-652-11, CC BY 2.0, https://commons.wikimedia.org/w/index.php?curid=6215100
</gallery>


==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:Infectious disease]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Ophthalmology]]
[[Category:Ophthalmology]]
[[Category:Immunology]]
[[Category:Primary care]]
{{WH}}
{{WS}}

Latest revision as of 20:38, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]

Overview

Physical examination of patients with blepharitis is usually remarkable for irritated eyelid edges, hard crusting of the lashes, entropion, ectropion, poliosis, and diffuse conjunctival injection.[1][2]

Physical Examination

Skin

Common skin examination findings of blepharitis include:[1][2][3]

Eye

Gross Eye Examination

Common eye examination findings of blepharitis include:[2][4][5]

Slit Lamp Examination

On slit lamp examination, blepharitis is characterized by:

Images

The following are images associated with blepharitis:[6]

References

  1. 1.0 1.1 Dougherty JM, McCulley JP (1986). "Bacterial lipases and chronic blepharitis". Invest Ophthalmol Vis Sci. 27 (4): 486–91. PMID 3957566.
  2. 2.0 2.1 2.2 THYGESON P, VAUGHAN DG (1954). "Seborrheic blepharitis". Trans Am Ophthalmol Soc. 52: 173–88. PMC 1312591. PMID 13274422.
  3. Lemp MA, Nichols KK (2009). "Blepharitis in the United States 2009: a survey-based perspective on prevalence and treatment". Ocul Surf. 7 (2 Suppl): S1–S14. PMID 19383269.
  4. Blepharitis. American Academy of Ophthalmology/eyewiki (2014). http://eyewiki.org/Blepharitis Accessed on July 14, 2016
  5. Blepharitis. National Eye Institute. (2009). https://nei.nih.gov/health/blepharitis/blepharitis Accessed on July, 14, 2016
  6. Tomlinson A, Bron AJ, Korb DR, Amano S, Paugh JR, Pearce EI; et al. (2011). "The international workshop on meibomian gland dysfunction: report of the diagnosis subcommittee". Invest Ophthalmol Vis Sci. 52 (4): 2006–49. doi:10.1167/iovs.10-6997f. PMC 3072162. PMID 21450918.