Rosacea blepharitis

Blepharitis is a broad term that refers to a collection of lid margin inflammatory disorders that cause changes in adjacent or surrounding structures and often includes, or is associated with, dermatologic conditions such as seborrhea and rosacea. The etiology remains poorly understood despite a strikingly high prevalence in the population it has been reported that approximately 590,000 patients per year seek care due to blepharitis, and it is estimated that 20 million people suffer from this disorder worldwide. 

Infections blepharitis is thought to be caused by a direct infection from bacteria that are either foimd in greater qnantity, are more virulent in nature, or are pathogenic in certain individnals. It has also been postnlated that patients with atopy or other dermatologic conditions (e.g., rosacea) are more likely to have blepharitis and are more prone to staphylococcal infections. Cnrrently S. aureus remains the primary suspect in bacterial and mixed variety blepharitis, although the exact mechanism remains a mystery. 

Etiology. Acne rosacea, better described as rosacea, may be associated with acne but is not caused by it. Rosacea is a chronic, fecial, inflammatory skin disorder frequently related to infectious blepharitis. Rosacea affects the face, nose, chin, and forehead. It has been reported to occur in up to 10% of the population and roughly 14 million Americans. It affects mostly fair-skinned individuals with an onset of between 20 and 50 years. It is characterized by periods of exacerbation that may be mild to very severe. One of the many forms of rosacea is ocular rosacea. 

Figure 23-10 Rosacea with severe blepharitis. Note the thickened lid margins and the corneal neovascularization. This is the same patient as seen in Figure 23-9. (From Palay DA, Krachmer JH. Conjunctival abnormalities. In Primary care ophthalmology, ed. 2. Philadelphia Mosby, 2005 98.)...

Rarely, a history of sensitization to an external agent can be identified. In these cases removal of the offending agent is the recommended treatment. Possible contributory or causal diseases, such as dry eye syndrome, acne rosacea, ocular allergic disease, or blepharitis, have been noted in up to 50% of episcleritis patients.These concurrent conditions should be treated if present. Full response to treatment in any patient who smokes can be delayed by a month or more. For this reason and because episcleritis... 

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