A 34-Year-Old Man with Pain and Burning in Both Eyes

Differential Diagnosis

• Allergic conjunctivitis
• Blepharitis
• Seborrheic dermatitis

Diagnosis

This patient was diagnosed with blepharitis, sometimes referred to as meibomitis, which is a chronic inflammatory condition of the eyelid margin associated with eye irritation. It is more common in individuals with fair skin phototypes and closely linked with dry eye syndrome.

Learnings/What to Look for

• Patients will commonly describe eyelid erythema, eyelid swelling, eyelid itching, foreign body sensation in the eye, burning of the eye, excessive tearing, blurry vision, photophobia and collections of matter around the eyelashes upon awakening
• Patients with blepharitis are also prone to having multiple styes or chalazions on the eyelids

Pearls for Urgent Care Management

• For minor blepharitis, first-line treatment is self-care measures—washing the eyes, lid massage, artificial tears and applying warm compresses
• If self-care measures do not resolve the problem, consider topical ophthalmic antibiotics (ie, erythromycin ophthalmic, bacitracin ophthalmic) in addition to self-care measures
• For severe cases, oral antibiotics such as tetracycline or doxycycline may be used

Acknowledgment: Images and case presented by VisualDx (www.VisualDx.com/JUCM).