Lid/Orbit
Blepharitis
Also known as: anterior blepharitis, posterior blepharitis, staphylococcal blepharitis, seborrhoeic blepharitis, seborrheic blepharitis, demodex blepharitis, collarettes, cylindrical dandruff
Filed as: Routine
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
A common chronic inflammatory lid-margin condition causing crusting, irritation, tear-film instability, and recurrent flares. This record covers practical anterior blepharitis and mixed lid-margin disease; Meibomian gland dysfunction has a separate deeper record for posterior gland obstruction. The safety task is to confirm a benign bilateral chronic lid-margin pattern, treat the lid disease consistently, and route corneal involvement, severe red-eye features, or unilateral atypical lid changes away from routine blepharitis care.
Recognition
Symptoms: what patients report
- Chronic or recurrent gritty, burning, stinging, itchy, or foreign-body sensation.
- Crusting or stickiness of the eyelids, often worse on waking.
- Intermittent tearing, mild redness, or lid irritation.
- Fluctuating blur that improves with blinking or surface lubrication.
- Dry-eye symptoms, especially with screen use, wind, dry air, or prolonged visual tasks.
- Recurrent flares rather than a single rapidly progressive episode.
Signs: what the examination shows
- Anterior lid-margin erythema with crusting, scales, or collarettes at the lash base.
- Cylindrical dandruff around lashes when Demodex is likely.
- Greasy lash debris in seborrhoeic patterns.
- Posterior lid-margin telangiectasia, capped glands, or thick/turbid meibum when MGD overlaps.
- Reduced tear break-up time or mild inferior punctate staining from tear-film instability.
- No corneal infiltrate, no dense epithelial defect, no significant AC reaction, and no destructive unilateral lid lesion in uncomplicated disease.
What OptoGuide™ covers for blepharitis
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Blepharitis - EyeWiki
- Blepharitis - StatPearls - NCBI Bookshelf
- Anterior Eye Disease and Therapeutics A-Z (Bruce & Loughnan) — standard reference text
- Sebaceous carcinoma: an updated review of pathogenesis, diagnosis, and treatment options. Dowell-Esquivel C, Lee R, DiCaprio RC, Nouri K. Archives of Dermatological Research. 2023;316(1):55.
- Ocular Manifestations of Rosacea: A Clinical Review. Tavassoli S, Wong N, Chan E. Clinical & Experimental Ophthalmology. 2021;49(2):104-117.
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.