Patient presents with whitish crusting at base of eyelashes with itching. What is the patient suffering from?
Ans. is 'a' i.e., Blepharitis o Complains of whitish deposition at the base of eye lashes with crusting suggests that the patient is suffering from infection of eyelid margin - blepharitis.BLEPHARITISo It is a subacute or chronic inflammation of the lid margins. It is an extremely common disease which can be divided into following clinical types:o Seborrhoeic or squamous blepharitis,o Staphylococcal or ulcerative blepharitis,o Mixed staphylococcal with seborrhoeicblepharitis,o Posterior blepharitis or meibomitis, ando Parasitic blepharitis.Seborrhoeic or squamous blepharitisEtiologyIt is usually associated with seborrhoea of scalp (dandruff).In it, glands of Zeis secrete abnormal excessive neutral lipids which are split by Corynebacterium acne into irritating free fatty acids.SymptomsPatients usually complain of deposition of whitish material at the lid margin associated with mild discomfort, irritation, occasional watering and a history of falling of eyelashes.SignsAccumulation of white dandruff-like scales are seen on the lid margin, among the lashes.On removing these scales underlying surface is found to be hyperaemic (no ulcers).The lashes fall out easily but are usually replaced quickly without distortion.In long-standing cases lid margin is thickened and the sharp posterior border tends to be rounded leading to epiphora.TreatmentGeneral measures include improvement of health and balanced diet. Associated seborrhoea of the scalp should be adequately treated.Local measures include removal of scales from the lid margin with the help of lukewarm solution of 3 percent soda bicarb or baby shampoo and frequent application of combined antibiotic and steroid eye ointment at the lid margin.
Blepharitis
Trichiasis
Districhiasis
Ectropion
Anomalies in the Position of Lashes and Lid Margin