A. Blepharitis

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Z A L D I

FAKULTAS KEDOKTERAN

UNIVERSITAS MUHAMMADIYAH SUMATERA UTARAMEDAN

2013

BLEPHARITIS

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Z A L D I BLEPHARITIS


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02/06/2014 7:22Z A L D I BLEPHARITIS2

Dengan menyebut nama Allah

Yang Maha Pengasih Maha Penyayang.


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I. TUJUAN INSTRUKSIONAL UMUM

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Setelah Proses Belajar Mengajar mahasiswa

mampu menegakkan diagnosa blefaritisdengan melakukan anamnese dan

pemeriksaan sederhana yang akan dipelajari

selama masa perkuliahan dengan baik danbenar .


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II. TUJUAN INSTRUKSIONAL KHUSUS


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mampu mengetahui tanda dan gejala , faktorresiko, prinsip pengobatan, komplikasi, dan

mengkonsulkan secara garis besar dengan

baik dan benar kasus-kasus blefaritis sesuaidengan kompetensinya


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II. TUJUAN INSTRUKSIONAL KHUSUS


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mampu mengetahui tanda dan gejala , faktorresiko, prinsip pengobatan, komplikasi, dan

mengkonsulkan secara garis besar dengan

baik dan benar kasus-kasus chalazion sesuaidengan kompetensinya


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SEBORRHOEIC BLEPHARITIS

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BLEPHARITIS

It is a subacute or chronic inflammation of thelid margins. It is an extremely common diseasewhich can be divided into following clinical

types: Seborrhoeic or squamous blepharitis,

Staphylococcal or ulcerative blepharitis,

Mixed staphylococcal with seborrhoeic

blepharitis, Posterior blepharitis or meibomitis,

Parasitic blepharitis.

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e orr oe c or squamousblepharitis

Etiology.

It is usually associated with seborrhoea of

scalp (dandruff). Some constitutional and

metabolic factors play a part in its etiology. Init, glands of Zeis secrete abnormal excessive

neutral lipids which are split by

Corynebacterium acne into irritating free fatty

acids

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SYMPTOMS

Deposition of whitish material at the lid margin associated with

mild discomfort,

irritation,

occasional watering and a

history of falling of eyelashes.

Signs. Accumulation of white dandruff-like scales are

seen on the lid margin, among the lashes (Fig. 14.7).

On removing these scales underlying surface is found

to be hyperaemic (no ulcers). The lashes fall out

easily but are usually replaced quickly without distortion. In long-standing cases lid margin is

thickened and the sharp posterior border tends to be

rounded leading to epiphora

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SIGNS

Accumulation of white dandruff-like scales are

seen on the lid margin, among the lashes

On removing these scales underlying surface

is found to be hyperaemic (no ulcers).

The lashes fall out easily but are usually

replaced quickly without distortion.

In long-standing cases lid margin is thickenedand the sharp posterior border tends to be

rounded leading to epiphora

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TREATMENT

Improvement of health and balanced diet.

Associated seborrhoea of the scalpshould be

adequately treated.

Local measures include removal of scales

from the lid margin with the help of lukewarm

solution of 3 percent soda bicarb or baby

shampoo and frequent application ofcombined antibiotic and steroid eye ointment

at the lid margin.

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ULCERATIVE BLEPHARITIS

ETIOLOGY

It is a chronic staphylococcal infection of the

lid margin usually caused by coagulase

positive strains.

The disorder usually starts in childhood and

may continue throughout life. Chronic

conjunctivitis and dacryocystitis may act aspredisposing factors.

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ULCERATIVE BLEPHARITIS

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SYMPTOMS

Chronic irritation,

Itching,

Mild lacrimation,

Gluing of cilia

Photophobia.

The symptoms are characteristically worse in the morning.

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SIGNS

Yellow crusts are seen at the root of cilia which

glue them together.

Small ulcers, which bleed easily, are seen on

removing the crusts.

In between the crusts, the anterior lid margin

may show dilated blood vessels (rosettes).

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COMPLICATIONS

Conjunctivitis,

Madarosis (sparseness or absence of lashes),

Trichiasis, poliosis (greying of lashes),

Tylosis (thickening of lid margin)

Eversion of the punctum leading to epiphora.

Eczema of the skin

Ectropion

Treatment. It should be treated promptly to avoid complication and sequelae. Crusts should be

removed

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TREATMENT

Hot compresses

Antibiotic ointment after removal of crusts

Antibiotic eyedrops

Oral antibioticssuch as erythromycin or

tetracyclines may be useful.

Oral anti-inflammatory

Avoid rubbing of the eyes or fingering of the lids.

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POSTERIOR BLEPHARITIS

( MEIBOMITIS )

1.Chronic meibomitis is a meibomian gland dysfunction,seen more commonly in middle-aged persons withacne rosacea and seborrhoeic dermatitis.

It is characterized by white frothy (foam-like) secretion

on the eyelid margins and canthi (meibomianseborrhoea). On eversion of the eyelids, verticalyellowish streaks shining through the conjunctiva areseen. At the lid margin, openings of the meibomianglands become prominent with thick secretions.

2.Acute meibomitis occurs mostly due to staphylococcalinfection

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TREATMENT

Treatment of meibomitis consists of expression of

the glands by repeated vertical lid massage,

followed by rubbing of antibiotic-steroid ointment

at the lid margin. Antibiotic eyedrops should be instilled 3-4 times.

Systemic tetracyclines for 6-12 weeks remain the

mainstay of treatment of posterior blepharitis.

Erythromycin may be used where tetracyclines

are contraindicated

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PARASITIC BLEPHARITIS

Blepharitis africa refers to a chronic blepharitis

associated with Demodex folliculoruminfection

and Phthiriasis palpebramto that due to crab-

louse, very rarely to the head-louse. In additionto features of chronic blepharitis, it is

characterized by presence of nits at the lid

margin and at roots of eyelashes.

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TREATMENT

Treatment consists of mechanical removal of

the nits with forceps followed by rubbing of

antibiotic ointment on lid margins, and

delousing of the patient, other family members,clothing and bedding

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REFERENCES


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American Academy of Ophthalmology, External

Disease and Cornea, Section 8, 2011-2012

Khurana AK, Comprehensive Ophthalmology, Fourth

Edition , New Delhi, New Age Internasional (p) LimitedPublisher, 2007.

Vaughan & Asbury's : General Ophthalmology

17th Edition , Mc Graw- HillsCompanies , May 2007


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Segala puji bagi Allah, Tuhan semesta alam.

Documents

A. Blepharitis