Blepharitis classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Blepharitis may be classified according to the affected lid structure delineated by the gray line (the muscle of Riolan) into anterior and posterior blepharitis. Alternatively, blepharitis can be classified based on meibomian gland morphology, tear osmolarity, and Schirmer test result into (1) seborrheic, (2) obstructive, (3) obstructive with sicca, and (4) sicca.
Classification
In 1992, Wilhelmus described a clinically useful approach to classify blepharitis based on the affected location of the lid margin delineated by the gray line (the muscle of Riolan).[1] The gray line divides the lid margin into an anterior lamella (skin, muscle, eyelash follicles, and glands of Zeis) and a posterior lamella (tarsus, conjunctiva, and meibomian glands).
According to the affected lid structure and the location of the predominant inflammation, marginal blepharitis can be divided into:
- Anterior blepharitis (inflammation of the anterior lamella)
- Posterior blepharitis (inflammation of the posterior lamella)
Based on the anatomic location, blepharitis may be classified into:[2]
- Anterior blepharitis (affects the front of the eyelids near the base of the eyelashes, eyelid skin, and the eyelash follicles)
- Staphylococcal blepharitis
- Seborrheic blepharitis (mainly anterior lid)
- Posterior blepharitis (affects the back of the eyelids, tarsal plate, meibomian glands, and gland orifices)
- Meibomian gland dysfunction (MGD)
- Seborrheic blepharitis
Based on the duration of symptoms, blepharitis may be classified into:[3]
- Acute blepharitis
- Chronic blepharitis
References
- ↑ Wilhelmus, K. R. "Inflammatory disorders of the eyelid margins and eyelashes." Ophthalmol Clin North Am 5.2 (1992): 187.
- ↑ Wilhelmus, K. R. "Inflammatory disorders of the eyelid margins and eyelashes." Ophthalmol Clin North Am 5.2 (1992): 187.
- ↑ Lemp MA, Nichols KK (2009). "Blepharitis in the United States 2009: a survey-based perspective on prevalence and treatment". Ocul Surf. 7 (2 Suppl): S1–S14. PMID 19383269.