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Blepharitis Pathway
Blepharitis is a common inflammatory eyelid condition caused by chronic staphylococcal infection and malfunction of the meibomian glands. It can cause secondary conjunctivitis, dry eye, and occasionally small corneal ulcers (marginal keratitis). It may be associated with rosacea which should be treated simultaneously.
Signs and Symptoms
- Usually chronic or slow onset but may wax and wane
- Gritty, sore, red eyes
- Eyelid crusting
- Red rimmed, thickened lid margins +/- mild to severe crusting on the eyelashes
- Blocked or oozing meibomian glands
- Red conjunctiva in some cases
- Usually, blepharitis can be treated by cleaning the eyelids every day. Eyelid hygiene which may need to be continued once acute inflammation settled to avoid further symptoms
- If blepharitis is severe or not controlled by eyelid hygiene alone, consider application of an antibacterial eye ointment. Associated dry eye can be treated with lubricants (Tear deficiency, ocular lubricants, and astringents) – please note that most products can be purchased over the counter at a cost less than the prescription charge
Referral Criteria
- Above measures trailed for more than 1 month and still severely symptomatic then refer routinely to OPD
- Severe pain or photophobia or any evidence of marginal keratitis (peripheral corneal staining with fluorescein) then Urgent referral
Referral Instructions
e-Referral Service Selection:
Specialty: Ophthalmology
Clinic Type: Oculoplastics/Orbits/Lacrimal or Not Otherwise Specified
Service: DRSS-South Devon & Torbay-Ophthalmology-Optom Only- Devon ICB- 15N
Referral Form
Pathway Group
This guideline has been signed off by NHS Devon
Publication date: May 2022
