The Role of Bacteria in Blepharitis

Abstract

linicians suspect that bacteria play an important role in blepharitis, but many questions remain about the precise nature of that role in the pathogenesis of clinical disease. Since some _~. bacterial colonization of the eyelids is normal and typically benign, possibly even beneficial, the presence of bacteria alone does not cause blepharitis. Instead, ongoing research suggests several possibilities; the condition may be due: to the wrong types of bacteria becoming established on the eyelids, too many bacteria colonizing this area, or an imbalance among the various bacterial species present. Further investigation of these possibilities is needed to fully elucidate the etiology of the most common forms of blepharitis, but our growing understanding of this condition has already helped to identify promising avenues for therapy. Since some of the symptoms of blepharitis result from in­ flammation, a drug with an immunomodulatory effect is likely to prove beneficial. In addition, since bacterial byproducts contribute to this inflammation, using mild lid scrubs to remove this material in combination with a broad spectrum antibiotic active against common lid flora will likely continue to playa role in treatment of these pervasive conditions. HOW BACTERIA CAUSE SYMPTOMS