Blepharitis historical perspective
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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 was first described in the late 19th century as "conjunctivitis meibomianae" in a patient with accumulated sebaceous-like material in the meibomian glands.
Historical Perspective
The terminology for blepharitis has evolved alongside the advance in its pathophysiology and treatment. Early terms used to describe related meibomian gland conditions include ophthalmia tarsi, puriform palpebral flux, polyadenitis meibomiana chronica suppurativa, conjunctivitis meibomianae, meibomian seborrhea, keratitis meibomiana, seborrheic blepharoconjunctivitis, meibomian keratoconjunctivitis, meibomianitis, and meibomitis.
The earliest description of blepharitis dates back to 1894, when Lydston reported the clinical entity "conjunctivitis meibomianae" in a patient with accumulated sebaceous-like material in the meibomian glands.[1]
In 1901, Maklahoff reported another case characterized by dilated meibomian gland openings with pus formation in the glands.[2]
In 1908, Elschnig described the symptom of meibomian gland hypersecretion which could be relieved by emptying of the glands and the use of astringents.[3]
In 1921, Gifford isolated Staphylococcus aureus and Bacillus xerosis from meibomian gland cultures of young and elderly individuals, respectively.[4]
In 1942, Scobee noted frequent isolation of staphylococci from meibomian gland cultures in both patients and normal controls. This finding suggested that colonization of microorganisms in the meibomian glands may play a role in the pathogenesis. Scobee also recommended the use of lid massage and adrenalin in conjunction with antiseptic eyedrops to promote drainage of the meibomian glands.[5]
In 1946, Thygeson proposed a classification of blepharitis based on the etiology: 1) seborrheic, 2) staphylococcal, 3) mixed seborrheic and staphylococcal, and 4) blepharitis due to Hemophilus duplex.[6]
Several terms indicating the site of involvement have been used extensively in the literature. The term "meibomian gland dysfunction", suggested by Gutgesell et al. in 1982, gained general acceptance and has been used to describe the clinical spectrum of meibomian gland abnormalities leading to blepharitis.
References
- ↑ Lydston, James A. "CONJUNCTIVITIS MEIBOMIANÆ." Journal of the American Medical Association 23.6 (1894): 241-242.
- ↑ Maklahoff, AA. "Zur Bactderchron eitrigen Entzund der Gland Meib des Lides." Arch fur Augenheilkd. 13.10 (1901).
- ↑ Elschnig, A. "Beitrag zur Aethiologie und Therapie der cronischen Konjunctivitis." Deuts Med Wochenschr 26 (1908): 1133-1135.
- ↑ Gifford, Sanford R. "The etiology of chronic meibomitis." American Journal of Ophthalmology 4.8 (1921): 566-570.
- ↑ Scobee, Richard G. "The Role of the Meibomian Glands in Recurrent Conjunctivitis: A Review with Experimental Observations." American Journal of Ophthalmology 25.2 (1942): 184-192.
- ↑ Thygeson, Phillips. "Etiology and treatment of blepharitis: a study in military personnel." Archives of Ophthalmology 36.4 (1946): 445-477.