Article

Ocular surface and lid margin diseases

Ocular surface and lid margin diseases

Bacterial conjunctivitis

This disease occurs when bacteria infect the conjunctiva, the thin, clear layer of tissue that lines the inside of the eyelid and covers the white part of the eye.1,2

What should l look for?

  • Redness, swelling, and thick crust (pus) in one or both eyes.1
  • Eyelids and eyelashes that are matted shut after sleeping.1
  • Discomfort and some sensitivity to light.1

What causes it?

  • Bacteria that are typically found on the skin.1

Why treat it?

  • To relieve discomfort and to keep the infection from getting worse.2
  • To avoid the spread of infection. Bacterial conjunctivitis clears up with time, but bacteria could spread to other parts of the eye, such as the cornea.1

Allergic conjunctivitis

This condition is an inflammation, caused by allergies, of the inner surface of the eyelid and the white part of the eye.2,3

What should I look for?

  • Itching, burning, teary eyes.3
  • Red, swollen eyelids and/or redness in the white of the eye or inner eyelid.3

What causes it?

  • Seasonal allergies caused by allergens such as pollen, grass, and other airborne particles.4
  • Year-round allergies caused by allergens such as animal dander, dust, and mold.4

Why treat it?

  • To help the eye look, feel, and function normally and to prevent problems from recurring.3
  • To prevent uncomfortable feelings in the eye, sensitivity to light, infection, and possible weakened vision.2,4

Bacterial keratitis

This condition occurs when bacteria infect the cornea, the clear covering over the front of the colored portion of the eyeball.5,8

What should I look for?

  • Pain and sensitivity to light; blurred or hazy vision.5,7
  • Watery and bloodshot eyes; thick discharge; a feeling as though there is something in the eye.5,7

What causes it?

  • Bacterial infections.5,6
  • Contact lenses tend to be the main risk factor.6

Why treat it?

  • To relieve symptoms and discomfort.5,7
  • To prevent complications such as damage to the surface of the eye, inner-eye infection, and weakened vision.7

Blepharitis

Blepharitis is a common condition that causes inflammation around the eyelid and eyelashes. It occurs in 3 forms, usually classified by location: the outer eyelid (anterior), the inner eyelid (posterior), or a combination of the 2 (mixed).9-11

Anterior

This disease causes inflammation around the outer (anterior) part of the eyelids and eyelashes.9,10

What should l look for?

  • Eyes: itchy, burning, scratchy, dry, or watery; a feeling as though there is something in the eye.9,11
  • Eyelids: inflamed, swollen, red, scaly, or crusty.9,11
  • Eyelashes: lost, broken, or misdirected; crusted lashes, especially right after waking up.9,11

What causes it?

  • Bacterial infection or excessive oils (associated with dandruff).9,11

Why treat it?

  • To make the eye look, feel, and function normally.10,12
  • To prevent further damage to the eye and avoid weakened vision.10,12
  • To reduce problems after eye surgery.12

Posterior or meibomian gland disease (MGD)

This disease causes inflammation around the inner (posterior) part of the eyelids and eyelashes.9,10

What should l look for?

  • Eyes: tired, itchy, burning, red, dry, or watery; a feeling as though there is something in the eye; light sensitivity; problems wearing contact lenses.10,11
  • Eyelids: sore, swollen, or inflamed; scalloping (row of small bumps) along lid edge; cysts.10,11

What causes it?

  • The meibomian glands become clogged with oil and inflamed, often because of bacteria. The meibomian glands are found along the rim of the eyelid.9,13
  • Other eye problems, such as dry eye and anterior blepharitis, may be associated.12
  • Some skin conditions, such as acne rosacea, are often associated.10

Why treat it?

  • To help the eye look, feel, and work normally.12
  • To reduce problems after eye surgery.12
  • To reduce the risk of additional eye problems occurring.12

References

  1. Sowka JW, Gurwood AS, Kabat AG. Bacterial conjunctivitis. Handbook of ocular disease management. Review of Optometry Online, http://www.revoptom.com/handbook/sect2c.htm. Accessed July 29, 2008.
  2. American Academy of Ophthalmology. Preferred Practice Pattern: conjunctivitis. http://one.aao.org/CE/PracticeGuidelines/PPP.aspx?sid=9955f101-a94b-4f8f-a3c9-15d014f613b9. Published January 2006. Accessed July 30, 2008.
  3. Sowka JW, Gurwood AS, Kabat AG. Allergic conjunctivitis. Handbook of ocular disease management. Review of Optometry Online, http://www.revoptom.com/handbook/oct02_sec2_2.htm. Published October 2002. Accessed July 29, 2008.
  4. Sowka JW, Gurwood AS, Kabat AG. Acute allergic conjunctivitis. Handbook of ocular disease management. Review of Optometry Online, http://www.revoptom.com/handbook/March_2004/sec2_4.htm. Published March 2004. Accessed August 1, 2008.
  5. Sowka JW, Gurwood AS, Kabat AG. Bacterial keratitis. Handbook of oculardisease management. Review of Optometry Online, http://www.revoptom.com/handbook/oct02_sec3_5.htm. Published October 2002. Accessed January 26, 2009.
  6. Sowka JW, Gurwood AS, Kabat AG. Bacterial keratitis. Handbook of oculardisease management. Review of Optometry Online, http://www.revoptom.com/handbook/ March_2004/sec3_1.htm. Published March 2004. Accessed January 21, 2009.
  7. American Academy of Ophthalmology. Preferred Practice Pattern: Bacterial keratitis. http://one.aao.org/CE/PracticeGuidelines/PPP_Content.aspx?cid=1d56d934-c309-4072-B6b5-0698559a3b47. Published 2008. Accessed January 21, 2009.
  8. National Eye Institute. Facts about the cornea and corneal disease. http://www.nei.nih.g0v/health/cornealdisease/index.asp#O. Updated December 2008. Accessed January 30, 2009.
  9. Sowka JW, Gurwood AS, Kabat AG. Blepharitis. Handbook of ocular disease management. Review of Optometry Online, http://www.revoptom.com/handbook/sect1a.htm. Accessed August 1, 2008.
  10. American Academy of Ophthalmology. Preferred Practice Pattern: blepharitis. http://one.aao.org/CE/PracticeGuidelines/PPP.aspx?sid=9955f101-a94b-4f8f-a3c9-15d014f613b9. Published September 2003. Accessed July 30, 2008.
  11. Jackson WB. Blepharitis: current strategies for diagnosis and management. Can J Ophthalmol. 2008;43(2):170-179.
  12. McDonald MB, O'Brien TP. New considerations in the treatment of anterior and posterior blepharitis. Refract Eyecare. 2008;12(4 suppl):1-14.
  13. Sowka JW, Kabat AG. A new option for blepharitis? Review of Optometry Online. 2008;145(11). http://www.revoptom.com/index.asp?page=2_14067.htm. Published November 15, 2008. Accessed December 5, 2008.