Objectives: Staphylococcal blepharitis is a common ocular condition that can cause significant visual morbidities due to corneal complications. This study described the clinical profile of patients with staphylococcal blepharitis seen in a tertiary referral eye center, and determined the frequency and the type of corneal complications, the possible reasons for the delay in diagnosis, and the management prior to the consult. Methods: This study was a single-center, five-year retrospective case series design. The charts of all patients from January 2016 to December 2021 with the diagnosis of staphylococcal blepharitis seen at the External Disease and Cornea Clinic of the Philippine General Hospital that have fulfilled the inclusion and exclusion criteria were included. The data extracted were age, sex, chief complaint, laterality, time of onset of symptoms to consult, previous consults, lid and lid margin findings, conjunctival and corneal findings, pre- and post-treatment uncorrected distance visual acuity, duration of follow-up, and treatments received. Results: Fifty-five (55) charts out of 107 charts with a diagnosis of staphylococcal blepharitis were included. Eighty percent (80%) or 44 patients had bilateral disease. Ninety-nine (99) eyes of 55 patients were analyzed. The median age of the study population was 19 years. Sixty-seven percent (67%) were female, and 33% were male. The mean duration of follow-up at the External Disease and Cornea Clinic was 10.8 ± 14.61 months. Corneal opacity, eye redness, and blurring of vision comprised 70% of the reasons for consult. The mean time from the onset of symptoms to consult was 18.36 ± 25.69 months. Sixty-seven percent (67%) had prior consults elsewhere and 45% came in with a different diagnosis. Seventy-eight (78) eyes had fibrin or crust on the lashes. Fifty percent (50%) of the eyes had concomitant conjunctivitis, while 30% had meibomitis. Fifty-eight percent (58%) of patients had corneal complications. Seventy-two percent (72%) of eyes had bilateral involvement. The median age of patients with corneal complications subgroup was 13 years. The most common corneal complications noted were neovascularization, phlyctenulosis, pannus formation, and marginal infiltrates or ulcers. Twenty-two percent (22%) of all study eyes had visually disabling corneal complications like corneal ulcer, descemetocele, corneal perforation, and corneal scar. Ninety percent (90%) of the patients received standard medical treatment and three patients underwent penetrating keratoplasty. The mean uncorrected distance visual acuity at initial consult of eyes with corneal complication was 20/55 (LogMAR 0.43 ± 0.51) and 20/35 (LogMAR 0.25 ± 0.40) after treatment (p = 0.032). Conclusion Staphylococcal blepharitis was most prevalent among young female patients, and it affected both eyes. Almost all patients manifested the typical lid margin lesions. Nearly 60% of the patients presented with corneal complications and 22% had corneal lesions that were potentially blinding. Close to 50% had delay in treatment due to misdiagnosis.
blepharitis ; staphylococcus ; cornea ; blindness

Demodex is a common ectoparasite in human eyelash. However the occurrence rate and pathogencity are still controversial. The purpose of this study were to investigate the occurrence rate and classification of Demodex from eyelashes and its relationship with blepharitis. We selected 28 blepharitis patients and 132 patients without blepharitis(control group) who vistied St. Family's Hostital from March 1992 to July 1992. The following results were obtained. Demodex was observed in 17 out of 28 blepharitis patients(60.7%) and in 32 out of 132 control group(24.2%). This difference was stastically significant(p<0.05). In blepharitis patients. Demodex index was 19.6 and lash index was 12.2. In control group. Democlex index 7.4 and lash index 5.3.
Blepharitis* ; Classification ; Eyelashes ; Humans ; Incidence*

Most common annoyant for angular blepharitis has long been known as a diplobacillus of Morax-Axenfeld since 1897. Bacteriological study has been done on 56 patients (102 eyes) being suffered from angular blepharitis clinically diagnosed in the Dept. of Ophthalmology, Yonsei University College of Medicine. Most angular blepharitis involved bilaterally (82%), 34 cases of angular blepharitis were seen in the nasal canthus (61%). Staphylococcus epidermidis was isolated from 50 eyes (49%) with angular blepharitis and staphylococcus au reus from 41 eyes (40%). No diplobacillus of Morax-Axenfeld was demonstrated in the culture from angular blepharitis.
Blepharitis* ; Humans ; Ophthalmology ; Staphylococcus ; Staphylococcus epidermidis

PURPOSE: To analyze the changes of tear composition in chronic blepharitis patients. METHODS: Tear samples were collected from 30 eyes of 29 patients diagnosed as chronic blepharitis by slit-lamp examination, and from 30 eyes of 30 normal volunteers. Chronic blepharitis group was subdivided into untreated group (10 eyes; tear sampling before the initiation of treatment) and treated group (20 eyes; tear sampling after the initiation of treatment). Tear pH, concentration of ions (Na+, K+, Cl-, Ca2+), total protein concentration and tear protein fraction (TPF) were measured. Statistical analysis was done by using Mann-Whitney U test and Kruscal-Wallis test, and p-valueblepharitis group was significantly alkaline (7.38) compared with that of control group (6.94). Though statistically insignificant, tear pH of the treated chronic blepharitis group (7.09) was slightly alkaline compared with that of control group. There was no significant difference in electrolytes and total protein concentrations among 3 groups. Tear protein analysis showed increased TPF4 in untreated (25.5%) and treated group (24.4%) compared with that in the control group (20.7%). CONCLUSIONS: Analysis of tear composition may be useful in understanding the pathophysiology of the chronic blepharitis and in evaluating the efficacy of the treatment.
Blepharitis* ; Electrolytes ; Healthy Volunteers ; Humans ; Hydrogen-Ion Concentration ; Ions ; Tears*

Two unusual cases (5yr. old girl and boy) of seborrhoic marginal blepharitis caused by infestation of pubiclice (Phthirus pubis) are described. Many pubic lice and their ova clung to the cilia of upper lid margin were identified as the cause of disease. Prompt improvement of marginal blepharitis limited only on upper lids of both eyes was brought by the removal of lice and epilation of cilia which there are many ova adhered on. These two cases have no interrelationship in possible contact or source. Their fainily history and envirvmnental studies showed in negative resuhs. Careful slit-lamp examination would be neccessary as a routine procedure in blepharitis cases.
Blepharitis* ; Cilia ; Female ; Hair Removal ; Humans ; Ovum ; Phthiraptera*

Demodex is easily found from eyelashes and suggested as the one of the causes of some eye diseases. This study was to investigate the occurence rate, and classification of Demodex from eyelashes, and its relationship with blepharitis. The data of this study were compiled from 27 blepharitis patients and 173 patients without blepharitis (control group) who had visited St. Paul's Hospital from October 1981 to December 1981. Three eyelashes from each eyelid-total 12 lashes from a patient-were extracted under the slit lamp, located on a slide glass and fixed with polyvinyl lactophenol mounting medium. (countinued..)
Blepharitis ; Classification ; Eye Diseases ; Eyelashes* ; Glass ; Humans ; Polyvinyls

PURPOSE: Diagnosis of tuberculous blepharitis may be delayed because of its nonspecific symptoms such as periocular edema, nodule, and papule. By investigating the route of infection and clinical course of tuberculous blepharitis, it was attempted to emphasize the importance of early diagnosis and treatment. METHODS: After the trial of intracanalicular plug removal, lid edema and nodule were developed in the patient who had been implanted a intracanalicular plug for dry eye. Excisional biopsy of the lesion was performed after treatment trial with local injection of triamcinolone acetonide. Many acid-fast bacilli were found in the microscopic examination. The patient underwent 9-month-scheduled anti-tuberculous medication. RESULTS: The lesion has improved with the medication. Lid ectropion occurred at the site of biopsy. CONCLUSIONS: Tuberculous blepharitis can be developed as a complication of intracanalicular plug procedure for dry eye. Tuberculous infection should be considered as a possible cause of longstanding blepharitis that is unresponsive to supportive treatment. It is emphasized that early diagnosis and proper management are important.
Biopsy ; Blepharitis* ; Diagnosis ; Early Diagnosis ; Ectropion ; Edema ; Humans ; Triamcinolone Acetonide

PURPOSE: To evaluate the efficacy and safety of acellular human dermis (AlloDerm) as a spacer graft in the correction of eyelid retraction. METHODS: We used acellular human dermis (AlloDerm) as a spacer in 8 patients with eyelid retraction. Two patients had upper eyelid retraction and 6 had lower eyelid retraction. The causes of the former were congenital (1) and ptosis operation (1), and of the latter were strabismus surgery (1), necrotizing blepharitis (1), blow-out fracture (1), anophthalmic socket contracture (1), cicatricial entropion (1), and lower lid blepharoplasty (1). The follow-up period ranged from 5 to 14 months (mean 9 months). RESULTS: Surgical results in 7 eyelids were satisfactory. There was mild overcorrection in one eyelid with congenital upper eyelid retraction. There were no other complications such as exposure, infection, or rejection. CONCLUSIONS: AlloDerm was easy to manipulate, closely approximated the eyelid tarsus in contour and thickness, and appeared to be nontoxic and nonallergenic. We suggest AlloDerm as the spacer material of choice for the treatment of eyelid retraction.
Allografts* ; Ankle ; Blepharitis ; Blepharoplasty ; Contracture ; Dermis ; Entropion ; Eyelids* ; Follow-Up Studies ; Humans ; Orbital Fractures ; Strabismus ; Transplants

PURPOSE: Although a number of clinical parameters are well known to affect dry eye (DE) disease, it is unknown which factor mostly affects the discomfort of DE. Blepharitis is recognized as one of the leading causes of evaporative-type DE disease, but there have been no large-scale study to investigate the effect of blepharitis on DE symptoms. The purpose of this study was to evaluate the factors influencing subjective ocular discomfort in DE patients with blepharitis and to determine which parameter is most highly related to severity of blepharitis. METHODS: This investigation was a cross-sectional, clinical study. The test population consisted of DE patients suffering from moderate blepharitis. Seventy-three subjects aged 22 to 81 years (mean age 56.36) were enrolled, 49 of whom completed the investigation on a total of 49 eyes. A detailed assessment was conducted, including history taking, visual analog scale (VAS) pain scoring, ocular surface disease index (OSDI) questionnaire, blepharitis severity grading (score 0-4), conjunctival, corneal fluorescein staining (score 0-4), and tear break up time (TBUT) assessment. RESULTS: The results revealed significant correlations between subjective symptoms and blepharitis severity. Significant increases in overall VAS score, OSDI score (p = 0.031, p = 0.006) were recorded in DE patients with severe blepharitis. Conjunctival erosion was significantly related to VAS score (p = 0.016). Other parameters were not significantly related with VAS and OSDI scores. Additionally, conjunctival erosion was related with blepharitis severity (p < 0.0001), and corneal erosion was not correlated with blepharitis severity. TBUT also did not show any statistical correlation with blepharitis. CONCLUSIONS: Our results showed that blepharitis severity is the main factor influencing subjective pain and discomfort in DE patients, although blepharitis severity was not related with the known clinical parameters of DE such as corneal erosion and TBUT. This study indicates that targeting treatment for blepharitis can significantly improve quality of life for patients suffering from DE disease.
Blepharitis* ; Clinical Study ; Fluorescein ; Humans ; Quality of Life ; Tears ; Visual Analog Scale

Adenocarcinoma of the Meibomian gland is very rare but lethal tumors. Clinically, most of the time sebaceous gland carcinoma is mistaken for a chalazion. Any recurrent chalazion should be submitted for histologic study, and any chronic, recalcitrant, atypical blepharitis should be biopsied. The treatment of the choice is excisional biopsy and followed by radiation therapy. A 30 year old Korean male had a hard, nontender mass on the left upper lid which had recurred after chalazion surgery. The tumor was removed surgically as repair with modified Wheeler direct full halving procedure, and found to be a adenocarcinoma of the Meibomian gland histopathologically. There was no evidence of recurrence and metastasis to remote site a year after surgery with radiation therapy.
Adenocarcinoma* ; Adult ; Biopsy ; Blepharitis ; Chalazion ; Humans ; Male ; Meibomian Glands* ; Neoplasm Metastasis ; Recurrence ; Sebaceous Glands