Blepharitis

Corneal changes include punctate epithelial erosions (fluorescein staining typically in inferior third of cornea), vascularisation, scarring, marginal ulcers, phlyctenular keratitis (limbal nodules), or perforation.

Mild cases may be managed with topical corticosteroids and antibiotics.

Ulceration and perforation need to be managed with aggressive antibiotics, adhesive therapy, and possibly surgery.

These patients should be referred promptly to an ophthalmologist for management.

Lash and lid margin changes include depigmentation of lashes, trichiasis (turning in of lashes), madarosis (loss of lashes), eyelid thickening and ulceration, and ectropion or entropion.

Trichiasis can be managed with manual or thermal epilation.

Ectropion and entropion require surgical lid procedures.

These patients should be referred to an ophthalmologist for management.