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Blepharitis
Introduction
- Cause: generalized skin disease, eg parasitic, bacterial, fungal, allergic or immune mediated.
- Signs: inflamed eyelids, ocular discharge.
- Diagnosis: signs, bacteriology, skin scraping, Wood's lamp examination.
- Treatment: often need systemic antibiotics +/- warm compresses.
- Prognosis: self-trauma is common complication; Staphylococcal blepharitis can be difficult to resolve.
Presenting signs
- Ocular irritation/discomfort.
- Coexistent conjunctivitis Conjunctivitis.
- Ocular discharge.
- Periorbital alopecia.
Age predisposition
- Autoimmune skin disease: age range is variable. No predilection age documented.
Cost considerations
- Prolonged antimicrobial treatment may be required.
- Autoimmune etiology may lead to costly/prolonged treatment.
Pathogenesis
Etiology
Parasitic
- Sarcoptic mange Sarcoptic mange which is sometimes pruritic.
- Demodectic mange Parasitic skin disease: overview rare and generally non-pruritic.
Fungal infection
- Microsporum canis (ringworm) Dermatophytosis often non-pruritc.
Bacterial
- Bacterial blepharitis with exudate and erythema and pruritus (may be chronic) - often associated with Staphylococcus spp Staphylococcus spp.
- Hordeolum (external stye).
- Chalazion (internal stye).
Allergic
- Characterized by eosinophilic or mast cell infiltration
- Atopy Skin: atopic dermatitis.
- Food Food hypersensitivity.
- Contact Skin: allergic contact dermatitis.
- Drugs Drug eruption.
- Flea allergic dermatitis Flea bite hypersensitivity.
Immune-mediated
- Pemphigus diseases Skin: pemphigus erythematosus.
Traumatic
- Actinic damage Dermatitis: solar (sunburn) leading to squamous cell carcinoma Squamous cell carcinoma
. - Burns may also affect ear tips and nose Burns.
Pathophysiology
- Underlying skin disease or infection (Staphylococcus spp Staphylococcus spp often isolated) → inflammation of eyelids. If abscess formation may → cicatricial entropion or ectropion .
- Many possible etiologies.
Timecourse
- Depends on cause.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Bistner S (1994) Allergic- and immunologic-mediated diseases of the eye and adnexae. Vet Clin North Am Small Anim Pract 24 (4), 711-734 PubMed.
- Glaze M B (1991) Ocular allergy. Semin Vet Med Surg 6 (4), 296-302 PubMed.
- Peiffer R L, Cook C S, Möller I (1984) Therapeutic strategies involving antimicrobial treatment of ophthalmic disease in small animals. JAVMA 185 (10), 1172-1175 PubMed.
- Peiffer R L Jr. (1980) Ocular immunology and mechanisms of ocular inflammation. Vet Clin North Am Small Anim Pract 10 (2), 281-302 PubMed.
Other sources of information
- Petersen-Jones S & Crispin S (2002) BSAVA Manual of Small Animal Ophthalmology. 2nd edn. British Small Animal Veterinary Association. ISBN 0 905214 54 4