Abstract
Chronic blepharitis leading to bilateral ulceration is rare to encounter. A 49-year-old African American female presents with bloody tears, severe pain, and photophobia in both eyes. Clinical presentation called for ulceration on the upper lid margins with excavated wound which bled on gentle rubbing. A systemic health review in combination of the symptoms and clinical picture led to the diagnosis of severe ulcerative blepharitis. Immediate oral antibiotics were started along with topical antibiotic cream. Ulcerative blepharitis can be easily misdiagnosed with sebaceous cell carcinoma. The pathophysiology of ulcerative blepharitis points to synergy between infectious entity and inflammatory aetiology, with either bacterial or fungal microorganisms as the trigger agents. Almost all cases of ulcerative blepharitis should include a dermatological evaluation given there is a strong association between ulcerative blepharitis and atopic dermatitis.
Highlights
IntroductionUlcerative blepharitis can be a clinical dilemma to diagnose and treat
Blepharitis is a very common condition encountered in our daily clinic
Patients are diagnosed with a mix of both anterior and posterior blepharitis, and present with chronic inflammation of the lid margins.[5]
Summary
Ulcerative blepharitis can be a clinical dilemma to diagnose and treat. Blepharitis involves both inflammatory and infectious entities. Almost all cases of ulcerative blepharitis are associated with atopic dermatitis.[3] A close clinical resemblance of lid margin ulceration with sebaceous cell carcinoma should not be neglected. Positive for hysterectomy, asthma, hypertension, and several flare up episodes of atopic dermatitis. On examination she was 20/25 OD and OS with very slow reading on Snellen acuity. Slit lamp exam revealed severe excavated wounds that were bleeding on both upper lid margins and a few erosive ulcerations on the lower lids Thinned eye lashes and several collarettes with loose epithelial scales bilaterally. Trace nuclear sclerotic cataracts was noted and the posterior segment exam was unremarkable
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