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PubMed2003

Monthly recurrent herpes simplex virus blepharitis in a boy for more than 10 years.

Ocular herpes simplex virus (HSV) infection is generally accepted to be a unilateral disease and simultaneous bilateral recurrent ocular HSV disease is uncommon. Recurrent ocular herpes was generally thought to be characterized by corneal involvement. We here report an 11-year-old boy with monthly bilateral recurrent HSV type 1 blepharitis for more than 10 years. He had a general normal immunological examination. Only supportive or topical acyclovir ointment treatment proved adequate for controlling the monthly recurrent disease without corneal involvement or other sequelae to date. The case highlights the unusual presentation, general normal immune function, clinical course and treatment opinion for recurrent HSV blepharitis.

Acyclovir↗
PubMed1992

[Unilateral chronic granulomatous blepharitis as a leading symptom of Oriental cutaneous leishmaniasis in Germany. Giesma stain as rapid diagnosis and initial description of systemic therapy with gamma-interferon].

Nine months after leaving the Lebanon, a four-year-old immigrant boy presented with a 5 months history of blepharitis. The lesion remained therapy-resistant for aminoglycoside antibiotics. Six months later, the patient presented with an indolent granulomatous necrotizing purulent blepharitis and follicular conjunctivitis. Diagnosis was made by Giemsa stain and histopathology, which revealed amastigotes in macrophages consistent with the diagnosis of oriental cutaneous leishmaniasis. Therapy with systemic recombinant gamma Interferon, which is described for the first time in this disease entity, resulted in a successful primary healing of the cutaneous lesion. Self-healing epithelial keratitis was the only side-effect observed. Ophthalmologists in Germany should be aware of the differential diagnosis of oriental cutaneous Leishmaniasis in patients suffering from chronic granulomatous lid lesions of patients from countries endemic/epidemic for Leishmaniasis. Laboratory diagnosis is simple. Insights into the immunology of infection have made possible novel therapeutic avenues using gamma-Interferon being effective without serve side-effects and allowing for a good primary healing of the cutaneous lesions.

Biopsy↗
PubMed1995

An in vitro comparison of the susceptibilities of bacterial isolates from patients with conjunctivitis and blepharitis to newer and established topical antibiotics.

This retrospective study compared new and established topical antibiotics with regard to the in vitro susceptibility of bacterial isolates recovered from patients with conjunctivitis (n = 385) and blepharitis (n = 173) using the National Committee for Clinical Laboratory Standards-approved disk diffusion method. The percent susceptibility of recovered isolates to single antibiotic agents or combinations were ranked from greatest to least: chloramphenicol, bacitracin/polymyxin B, ofloxacin, sulfa, ciprofloxacin, trimethoprim/polymyxin B, norfloxacin, gentamicin, bacitracin, trimethoprim, tobramycin, neomycin, erythromycin, and polymyxin B. We determined that none of the available topical antibiotics provided 100% broad spectrum coverage in vitro. Established antibiotics often provided coverage comparable to the newer drugs. Due to the unproven value of in vitro testing as a predictor of clinical outcome in bacterial blepharitis and conjunctivitis, the ophthalmologist should choose therapy based on clinical experience, ongoing critical evaluation of available antibiotics, and cost-effectiveness.

Administration, Topical↗
PubMed2005

Is it blepharitis?

Blepharitis is a ubiquitous disease and arguably, among the most common conditions that eye care practitioners encounter. Usually, its diagnosis is straight forward. However, any deviation from its predicted clinical appearance should cause the practitioner to consider other possibilities. The patient described in this report was diagnosed with blepharitis and treated as such. However, the true cause of her difficulties was basal cell carcinoma. This condition is briefly reviewed.

Adult↗
PubMed1986

Tear film flow and stability in herpes simplex keratitis and chronic blepharitis.

Tear film flow and stability studies were carried out in patients suffering from herpes simplex keratitis and chronic blepharitis by performing Schirmer test I and tear film break-up-time (BUT) measurements. In herpes simplex keratitis the values of BUT were within normal limits. Values of Schirmer test I were significantly higher (t-test, P less than 0.001) in these patients and are considered to be due to reflex hypersecretion of tears. Schirmer test I was found to be unaffected, whereas the values of BUT seen were significantly lower (t-test, P less than 0.001) in patients suffering from chronic blepharitis. These lower values of BUT can perhaps be attributed to the altered resurfacing of precorneal tear film as a result of changes in the lid margins.

Blepharitis↗
PubMed1984

Comparative bacteriology of chronic blepharitis.

One hundred and fifteen patients with chronic blepharitis were compared with 47 normal controls. Six clinically distinct groups of blepharitis were observed: staphylococcal; seborrhoeic, alone, with associated staphylococcal superinfection, meibomian seborrhoea, or secondary inflammation of the meibomian glands; and meibomian keratoconjunctivitis (MKC). Staphylococcus aureus was isolated in appreciable frequency from the staphylococcal and the mixed staphylococcal/seborrhoeic groups in contrast to the normal and non-staphylococcal groups. Coagulase-negative Staphylococcus spp., Propionibacterium acnes, and cornyneform bacteria were the most commonly isolated bacteria from the lid for all groups. Cultures of material expressed from the meibomian glands yielded similar organisms but in reduced frequency. Testing of antibiotic susceptibility revealed Staph aureus to be usually sensitive to most commonly used ophthalmic antimicrobials except sulphonamides.

Anti-Bacterial Agents↗
PubMed1991

Effect of I-Scrub on signs and symptoms of chronic blepharitis.

To assess the effect of I-Scrub (Spectra Pharmaceutical Services), a new detergent eyelid scrub, on the subjective symptoms and objective clinical signs of chronic blepharitis, 20 patients with this disease were treated for three weeks. None of them yielded positive cultures for virulent bacteria from the eyelids and conjunctiva. Most of the patients reported significant reduction in the subjective symptoms and in the severity of the clinical signs as well. No adverse effects were observed. The results of our study suggest that this product is of value as a detergent eyelid scrub in the treatment of chronic blepharitis.

Aged↗
PubMedDate not supplied

Ciprofloxacin ophthalmic solution versus rifamycin ophthalmic solution for the treatment of conjunctivitis and blepharitis.

The efficacy and safety of ciprofloxacin (0.3%) ophthalmic solution and rifamycin (1%) ophthalmic solution for the treatment of bacterial conjunctivitis and blepharitis was compared in this randomized, double-masked, parallel-group study. Forty-one patients, 19 on ciprofloxacin and 22 on rifamycin, were culture-positive on admission and evaluated for efficacy. There was clinical improvement in more than 90% of patients in each group at the end of the seven-day treatment period. However, clinical cure rates on day 7 appeared to be higher with ciprofloxacin (53%) than rifamycin (23%; p = 0.061, Mann-Whitney test). Bacteriological eradication rates were comparable: the infecting organisms were eradicated in 68% of patients on ciprofloxacin and 77% with rifamycin. There were no serious adverse reactions to either treatment. One patient in each group was withdrawn on account of a mild allergy. In conclusion, topical ciprofloxacin was effective and well tolerated and would be a particularly useful agent for the treatment of bacterial conjunctivitis and blepharitis.

Acute Disease↗
PubMedDate not supplied

Ciprofloxacin ophthalmic solution in the treatment of conjunctivitis and blepharitis: a comparison with fusidic acid.

The efficacy and safety of ciprofloxacin ophthalmic solution (0.3%) and fusidic acid gel (1%) were compared in the treatment of bacterial conjunctivitis and blepharitis in a randomized, open, parallel group study. Thirty-nine patients, 21 treated with ciprofloxacin solution and 18 treated with fusidic acid gel, were culture-positive on admission and were evaluable for efficacy. At the end of a 7-day treatment, the infecting organism was eradicated in 81% of those treated with ciprofloxacin and 72% of those treated with fusidic acid gel. There was clinical cure or improvement in 95% and 89% respectively. The clinical cure rate appeared to be higher with ciprofloxacin than fusidic acid (62% compared with 28%) but this was related to the higher proportion of patients with acute conjunctivitis in the ciprofloxacin group. Two patients using ciprofloxacin had mild discomfort and stinging on instillation and one given fusidic acid had moderate edema and discomfort; the latter patient stopped treatment. Topical ciprofloxacin is effective and well tolerated and is a useful treatment of bacterial conjunctivitis and blepharitis.

Adolescent↗
PubMed2002

A case of seborrheic blepharitis; treatment with itraconazole.

We report a case of seborrheic blepharitis treated with oral itraconazole during a short period. Direct examination using Parker KOH revealed numerous hyphae and spores of Malassezia in the scale. Low-dose itraconazole pulse therapy (200 mg daily, 7 days a month) was quite effective. This is the second case in which we also observed a unique fungal conformation which looked like tinea versicolor. The evidence strongly suggests that Malassezia is one of the major causative agents of seborrheic blepharitis.

Administration, Oral↗
PubMedDate not supplied

Dry eye, blepharitis and chronic eye irritation: divide and conquer.

Dry eye and posterior blepharitis are the two most common causes for chronic eye irritation. Dry eye is caused by loss of water from the tear film resulting from either decreased tear production or increased tear film evaporation. The resultant increase in tear film osmolarity causes the changes on the eye surface responsible for the symptoms of dry eye. Posterior blepharitis causes eye irritation from inflammation, and leads to the development of meibomian gland dysfunction. The patient history is a powerful tool in narrowing the differential diagnosis of chronic eye irritation or even establishing the diagnosis. The exam adds power to the history, and sorts out the mechanisms causing dry eye symptoms. The primary goal of dry eye treatment is to lower elevated tear film osmolarity. This can be achieved with TheraTears treatment, either with or without punctal plugs. The primary goal of meibomitis treatment is to reduce inflammation. This can be achieved by hot compresses and lid massage and, when necessary, systemic treatment with low dose doxycycline. By determining the cause or causes of chronic eye irritation, effective treatments can be employed.

Blepharitis↗
PubMedDate not supplied

Chronic blepharitis: easy nursing interventions for a common problem.

1. Blepharitis is a chronic, usually bilateral, inflammation of the eyelid margins. It is a lifelong condition, difficult to eradicate, and requires constant vigilance to restrain its irritating manifestations. 2. Treatment includes elimination of the scale caking the eyelids and eyebrows; removal of the offending bacteria, the materials they grow on, and the debris they leave; and healing the affected areas. 3. Scrupulous eye hygiene along with good handwashing habits will keep most cases of blepharitis under control. Contact lens wearers must be careful of cross-contamination between eye, lens, lens solutions, or lens cases, and cosmetics should be used properly and with care.

Blepharitis↗
PubMed2005

[Chronic blepharitis caused by mite Demodex folliculorum].

Two cases of the very long term observation and clinical findings of chronic blepharitis caused by mite Demodex folliculorum are presented. Both patients were treated for over ten years for inflammation of the margin of the eyelid with antibiotics and steroids administered locally. A significant thickening of the blood vessels in the eyelid and numerous cylindrical cuffs of dry discharge around the base of the eyelashes persuaded us to carry out microbiological tests on the suspect eyelashes. In both cases we received additional test results from the epilated eyelashes. Demodex folliculorum should be taken into consideration as an etiological factor in cases of chronic blepharitis.

Blepharitis↗
PubMed1986

Analysis of the free fatty acid component of meibomian secretions in chronic blepharitis.

Meibomian secretions were collected from 43 patients with chronic blepharitis and 8 normal controls. Patients were divided into six clinically distinct groups of chronic blepharitis. Individual secretions were weighed and separated into specific lipid classes by thin-layer chromatography. The free fatty acid (FFA) fraction was recovered, methylated, and analyzed by gas-liquid chromatography. Quantitation was achieved through the use of an internal standard, and qualitative analyses were aided by the use of commercial external standards. Carbon numbers were expressed in terms of their equivalent chain lengths (E.C.L.). For statistical comparisons, specific acid weights were expressed as nanograms per milligram of secretion. Data from individual subjects were tabulated by group and analyzed by a nonparametric analysis of variance. The FFA portion made up from 0.21% to 1.3% of the total meibomian secretion. Acids ranged in length from 12 to 29 carbon atoms. Iso-branched and anteisobranched carbon chains made up approximately 33% of the FFA fraction. E.C.L.'s corresponding to C16:0, C18:0, and C18:1 together made up a major portion of the total FFA fraction (mean = 49%). When compared to normals, a significantly decreased amount of C12:0 was seen in the mixed seborrheic/staphylococcal group and the meibomian seborrhea group. A significantly decreased amount of anteiso-branched C15:0 was seen in the mixed seborrheic/staphylococcal group. Significantly decreased amounts of anteiso-branched C23:0 were seen in all of the seborrheic blepharitides. A significantly increased amount of isobranched C22:0 was seen in the meibomian keratoconjunctivitis group. No significant differences were seen in the staphylococcal group.

Blepharitis↗
PubMed1984

Staphylococcal bacterin for treatment of chronic staphylococcal blepharitis in the dog.

A homologous Staphylococcus aureus bacterin was used successfully in the treatment of chronic staphylococcal blepharitis after antibiotic and corticosteroid therapy had not prevented disease recurrence. Of 44 dogs with staphylococcal blepharitis, 31 responded to the antibiotic/corticosteroid treatment, whereas 13 also required injections of bacterin to promote regression of clinical signs. Weekly bacterin injections controlled clinical signs without adverse side effects.

Animals↗
PubMed1995

Chronic blepharitis: a review.

Although blepharitis is one of the most common ocular disorders encountered in clinical practice, it may constitute a diagnostic and therapeutic enigma. Attempts to classify this disorder are difficult because of the complex mechanisms underlying its pathogenesis. Clinical and laboratory investigations have clearly established bacteria and meibomian gland abnormalities as major etiologic determinants. In addition, changes in tear film dynamics and underlying dermatologic abnormalities appear to contribute to pathogenesis. The clinical manifestations primarily occur along the lid margin, and the predominant symptoms are itching and burning. Currently there is no cure for this condition. In the case of staphylococcal blepharitis, for example, there is no long-term cure because patients are likely susceptible to the causative organism(s), and thus become reinfected. Therapy is aimed then at bringing the disease process under control. A therapeutic regimen consisting of lid hygiene, topical or systemic antibiotics, and tear replacement seems to be most effective in alleviating symptoms and maintaining disease control but requires prolonged treatment.

Bacteria↗
PubMed1995

[Microsporum canis tinea ciliaris and blepharitis].

INTRODUCTION: The involvement of eyelashes and eyelids by dermatophytes is unfrequent. CASE REPORT: We describe such a case in a 48 year old woman, who presented with unilateral blepharitis, resistant to topical treatments with antiseptics, antibiotics and corticosteroids. Diagnosis was suspected by magnifying lens and Wood's light examination; Microsporum canis was isolated from broken eyelashes and scales of annular lesions of eyelids. CONCLUSION: This case emphasizes the interest of mycological examination of eyelashes and eyelids in front of a persisting unilateral blepharitis.

Blepharitis↗
PubMed1996

A comparative study of eyelid cleaning regimens in chronic blepharitis.

PURPOSE: Blepharitis, an intrinsic eyelid inflammation with crusting and irritation, presents a great problem for patients wearing contact lenses. An important part of blepharitis therapy is eyelid hygiene, including the use of either soap, dilute baby shampoo, or commercial lid scrubs. In this study, a comparison was made between these three cleaning regimens in a group of 25 patients, 80% of whom (20/25) wore contact lenses. METHODS: Patients used commercial eyelid scrub on right eyelids and a hypo-allergenic bar soap on left eyelids. Patient symptoms, slit lamp findings, and overall preferences were determined at the end of 4 months. A subgroup of 10 patients using lid scrub on right eyelids and dilute baby shampoo on left eyelids was followed for an additional 3 months. RESULTS: At the end of 4 months, 24% (6/25) of the patients noted no difference between soap and lid scrub, but 89% (17/19) of the others preferred the lid scrub. In the group using baby shampoo, 50% (5/10) noted no difference in 3 months, but 80% (4/5) of the remaining patients preferred the lid scrub. CONCLUSIONS: All patients improved in slit lamp findings with all three regimens, and patient preference was overwhelmingly in favor of the lid scrub regimen for convenience and ease of use.

Adult↗