Opthal: Blepharitis: Free MSRA Podcast

👁️ MSRA Podcast: Blepharitis – Red, Sore Lids ExplainedLet’s explore Blepharitis, a chronic eyelid inflammation that’s one of the most common causes of sore, irritated eyes seen in GP and ophthalmology clinics.🧠 Definition & Types• Inflammation of eyelid margins – usually bilateral and chronic• Anterior = lash line (bacterial/seborrhoeic) → “A for At the lashes”• Posterior = meibomian glands (MGD-related, rosacea) → “P for Poor oil production”⚠️ Causes & Risk Factors• Bacterial colonisation, seborrhoeic dermatitis• MGD, dry eyes, rosacea, eczema, psoriasis• Allergies, ageing, contact lens use, Demodex mites🔬 Pathophysiology• Debris/oil at lid margin → bacterial overgrowth → immune response• Posterior: gland blockage → tear film disruption• Anterior: flaky lash line (often staph/seborrhoeic)👁️ Symptoms• Red, itchy, gritty eyelids• Morning crusting/sticking• Watery or dry eyes• Blurred vision (tear film instability)• Usually affects both eyes🔎 Signs on Exam• Inflamed lid margins• Lash crusting/flakes (anterior)• Blocked or greasy glands (posterior)• Skin findings: eczema, rosacea• Look for trichiasis, madarosis, or secondary conjunctivitis🧪 Diagnosis• Clinical diagnosis based on symptoms and exam• Slit lamp in persistent/severe cases• Swabs/biopsy if refractory, atypical, or suspicious for malignancy🧠 Differential Diagnosis• Conjunctivitis, chalazion, hordeolum• Ocular rosacea, contact dermatitis• BCC, SCC, sebaceous carcinoma• Impetigo, periorbital cellulitis📊 Epidemiology• Affects up to 37% of UK adults• ~5% of GP eye consults• More common with age, skin conditions💊 Management• Cornerstone: – Warm compresses (5–10 min, twice daily) – Lid hygiene (baby shampoo, lid wipes)• Artificial tears for dry eye relief• Topical antibiotics (e.g., fusidic acid, chloramphenicol) for persistent/severe cases• Oral doxycycline if: – Severe posterior blepharitis – Associated rosacea – Unresponsive to topical Rx• Avoid topical steroids in primary care• Consider omega-3 supplements• Treat underlying conditions: rosacea, seborrhoeic dermatitis📤 Referral When?• Atypical or suspicious lesions• Vision loss, keratitis• No improvement with treatment• Severe or recurrent cases• Suspected malignancy or cellulitis⚠️ Complications• Stye, chalazion• Lash issues: trichiasis, madarosis, poliosis• Eyelid deformities, dry eye, contact lens intolerance• Conjunctivitis, keratitis, corneal ulcers (vision-threatening)📉 Prognosis• Relapsing–remitting, chronic• Symptoms controlled well with consistent lid hygiene• Permanent damage rare with good care📚 MSRA Revision Resources📝 Notes: https://www.passthemsra.com/topic/blepharitis-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/blepharitis-flashcards/📖 Q&A Accordions: https://www.passthemsra.com/topic/blepharitis-accordion-qa-notes/🎯 Rapid Quiz: https://www.passthemsra.com/topic/blepharitis-rapid-quiz/🧪 Full Quiz: https://www.passthemsra.com/quizzes/blepharitis/🌐 More ophthalmology revision: https://www.passthemsra.com | https://www.freemsra.com🏁 Key Takeaways• Common cause of sore, gritty eyelids• Needs long-term lid hygiene• Topical/oral antibiotics for refractory cases• Refer for vision loss, atypical signs, keratitis, or persistent symptoms#MSRA #Blepharitis #Ophthalmology #RedEye #LidHygiene #PasstheMSRA #FreeMSRA #MSRAFlashcards #MSRARevision #ChronicEyeConditions #EyeCare #GPRevision #UKGuidelines