Materiały źródłowe

• #1 Blepharitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459305/

  Blepharitis is a chronic inflammatory condition affecting the eyelid margins and is one of the most common reasons patients seek care from ophthalmologists and optometrists worldwide. […] Although the exact cause of blepharitis remains unclear, germs and inflammation are believed to contribute. […] The establishment of standardized treatment procedures is further complicated by the fact that the pathophysiology of blepharitis involves several pathways that are currently poorly understood. […] The exact pathophysiology of blepharitis remains unclear but is likely multifactorial. Contributing factors include chronic low-grade bacterial infections of the ocular surface, inflammatory skin conditions such as atopy and seborrhea, and parasitic infestations with Demodex mites. Inflammation, bacterial colonization, and glandular dysfunction intricately interact in the pathophysiology of blepharitis, leading to tear film breakdown and persistent ocular surface discomfort.

• #1 Blepharitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459305/

  Although the 2 main types of blepharitis, anterior and posterior, involve somewhat different underlying mechanisms, they share inflammatory pathways that ultimately result in symptoms that are identical. In anterior blepharitis, the eyelid margin is directly colonized by bacteria, commonly Staphylococcus species. These bacteria release toxins and enzymes, such as lipase, that break down lipids, producing cytotoxic and pro-inflammatory free fatty acids. These fatty acids destabilize the tear film’s lipid layer. Prolonged exposure to these free fatty acids can lead to corneal damage in addition to causing discomfort.

• #1 Blepharitis (Inflamed Eyelids) | Doctor

  https://patient.info/doctor/blepharitis-pro

  Anterior blepharitis is usually caused by staphylococcus (staphylococcal blepharitis) or a seborrhoeic disorder (seborrhoeic blepharitis). […] Staphylococcal blepharitis is associated with bacteria on the ocular surface. The pathophysiology is complex and not fully understood. It may involve direct bacterial infection, exotoxin hypersensitivity, or delayed cell-mediated immune hypersensitivity response. Other bacteria may be involved, for example, streptococci, pseudomonas. […] Seborrhoeic blepharitis is closely associated with seborrhoeic dermatitis. Oily secretions increase and the skin becomes scaly and greasy. […] Posterior blepharitis usually results from meibomian gland dysfunction. This is a chronic, diffuse abnormality of the meibomian glands characterised by terminal duct obstruction and/or changes in glandular secretion.

• #1 Blepharitis | Concise Medical Knowledge

  https://www.lecturio.com/concepts/blepharitis/

  Posterior blepharitis: functional abnormality of the meibomian glands altered meibum composition. […] Stagnant material and altered lipid composition promotes bacterial growth inflammation. […] Chronic inflammation damages eyelid structure and further facilitates gland dysfunction. […] Anterior blepharitis: mechanism not fully understood but pathways include direct infection from Staphylococcus colonization. […] Irritation from bacterial toxins and cell-mediated inflammatory response from antigens. […] Implication of parasitic infestation (Demodex mites): Treatment of Demodex improves refractory blepharitis but exact role is still unclear.

• #1 Blepharitis – EyeWiki

  https://eyewiki.org/Blepharitis

  Blepharitis, an inflammatory condition of the eyelid margin, is a common cause of ocular discomfort and irritation in all age and ethnic groups. […] While the etiology of blepharitis is complex and not fully understood, bacteria and inflammation are believed to contribute to the pathology. Long-term management of symptoms may include daily eyelid cleansing routines and the use of therapeutic agents that reduce infection and inflammation. […] The exact pathogenesis of blepharitis is unknown, but suspected to be multifactorial. […] Staphylococcal blepharitis is believed to be associated with staphylococcal bacteria on the ocular surface. […] The mechanism by which the bacteria cause symptoms of blepharitis is not fully understood, and may include direct irritation from bacterial toxins and/or enhanced cell-mediated immunity to S. aureus.

• #1 Blepharitis – Wikipedia

  https://en.wikipedia.org/wiki/Blepharitis

  The mechanism by which the bacteria causes symptoms of blepharitis is not fully understood and may include direct irritation of bacterial toxins and/or enhanced cell-mediated immunity to S. aureus. […] Staphylococcal blepharitis is caused by an infection of the anterior portion of the eyelid by Staphylococcal bacteria. […] Meibomian gland dysfunction is a result of abnormalities of the meibomian glands and altered secretion of meibum, which plays an imperative role in lagging the evaporation of tear films and smoothing of the tear film to produce an even optical surface. […] Posterior blepharitis is an inflammation of the eyelids, secondary to dysfunction of the meibomian glands. Like anterior blepharitis, it is a bilateral chronic condition and may be associated with skin rosacea. […] There is growing evidence that, in some cases, it is caused by demodex mites.

• #1 Blepharitis pathophysiology – wikidoc

  https://www.wikidoc.org/index.php/Blepharitis_pathophysiology

  The exact pathogenesis of blepharitis is not fully understood. It is thought that blepharitis is caused by either bacterial colonization in the eyelids or meibomian gland dysfunction. […] However, in most cases of blepharitis, there is a considerable pathogenesis overlap between anterior and posterior blepharitis. […] The exact pathogenesis of anterior blepharitis is not fully understood. It is thought that blepharitis is caused by bacterial colonization (Staphylococcus aureus or Staphylococcus epidermidis) in the eyelids. Following bacterial colonization, bacterial lipase changes meibomian gland secretions and increases cholesterol concentration. These changes may result in an environment that affects the ocular surface and tear evaporation. […] It is thought that anterior blepharitis may also be caused by allergic response to bacterial antigens (mostly staphylococcal antigens).

• #1 Blepharitis – UpToDate

  https://www.uptodate.com/contents/blepharitis/print

  Blepharitis is classified as either posterior or anterior. However, there tends to be considerable overlap of both types, with a predominance of posterior. The etiology and pathophysiology of blepharitis differ somewhat based on the type (posterior versus anterior). […] Posterior blepharitis, the more common type, is characterized by inflammation of the inner portion of the eyelid at the level of the meibomian glands. Meibomian glands are modified sebaceous glands, located within the tarsal plates of the eyelids, responsible for secretion of the oily layer of the tear film. This oily layer prevents tear evaporation, reduces the surface tension of the tear layer, and facilitates the spread of tears. It is critical for normal eye lubrication. […] Hyperkeratinization of the meibomian gland ductal epithelium is an early finding in patients with posterior blepharitis. Altered lipid composition in gland secretions leads to instability of the tear film. The abnormal secretions also have a direct toxic effect on the ocular surface. Additionally, the altered lipid composition provides an environment that promotes bacterial growth, which perpetuates the meibomian gland abnormalities. Long-term inflammation leads to gland dysfunction and fibrosis as well as damage to the eyelid and ocular surface. […] The pathophysiology of anterior blepharitis is not completely understood, although lid-colonizing staphylococcal bacteria appear to play a role in some cases.

• #1 Blepharitis – EyeWiki

  https://eyewiki.org/Blepharitis

  Meibomian gland dysfunction is characterized by functional abnormalities of the meibomian glands and altered secretion of meibum, which plays an important role in slowing the evaporation of tear film and smoothing the tear film to provide an even optical surface. […] Both quantitative deficiencies in meibum or qualitative differences in its composition can contribute to symptoms experienced in MGD blepharitis.

• #1

  https://www.healio.com/news/ophthalmology/20120331/incidence-prevalence-and-pathophysiology-of-ocular-surface-disease-and-blepharitis

  Blepharitis refers to inflammation of the glands and lash follicles along the margin of the eyelids, hence the use of lid margin disease to describe the condition. […] Anterior blepharitis can be either infectious or seborrheic, whereas posterior blepharitis affects the meibomian glands, which play a critical role in tear film integrity. […] Posterior blepharitis produces dry eye symptoms due to altered meibomian gland secretions that result in abnormalities of the lipid layer of the tear film. […] In patients with meibomian gland disease, the composition of the secretions changes, which can lead to inflammation, irritation, and an unstable, altered tear film. The normal lipids that are secreted by the meibomian glands are triglycerides. With age, and in patients with meibomian gland disease, these triglycerides often degrade into proinflammatory monoglycerides and diglycerides.

• #1 Understanding Demodex Blepharitis Pathogenesis

  https://www.ajmc.com/view/understanding-demodex-blepharitis-pathogenesis

  Demodex is a very common eyelash mite found in most US patients, causing blepharitis and inflammation. […] It is now known that blepharitis is overwhelmingly associated with Demodex infestation. […] When seeing infected patients, Donnenfeld explains how eradicating Demodex can improve their ocular surface disease. […] Demodex blepharitis causes eyelid inflammation, redness, and occlusion, but patients cannot self-diagnose. […] Healthcare professionals must recognize collarettes indicating Demodex blepharitis and look for them. […] Previously, Demodex’s role was misunderstood and no FDA-approved treatments existed. […] Now an effective approved medication manages Demodex, improving ocular disease. […] All eye care professionals should understand Demodex’s role in blepharitis and test for it routinely.

• #1

  https://journals.lww.com/co-allergy/fulltext/2010/10000/pathogenic_role_of_demodex_mites_in_blepharitis.16.aspx

  Two distinct Demodex species have been confirmed as a cause of blepharitis: Demodex folliculorum can cause anterior blepharitis associated with disorders of eyelashes, and D. brevis can cause posterior blepharitis with meibomian gland dysfunction and keratoconjunctivitis. […] The pathogenesis of Demodex blepharitis in eliciting ocular surface inflammation has been further clarified. […] Tea tree oil shows promising potential to treat Demodex blepharitis by reducing Demodex counts with additional antibacterial, antifungal, and anti-inflammatory actions.

• #1 Diagnosis and Management of Blepharitis

  https://www.reviewofophthalmology.com/article/diagnosis-and-management-of-blepharitis

  Additionally, because the microbiota of the tear film is dependent upon proper meibomian gland function, a proliferation of pathogenic microbes may take place, including the proliferation of Staphylococcus, Streptococcus, Corynebacterium and Cutibacterium species. […] Blepharitis can also result from activity of the mite Demodex folliculorum, a parasite that has been identified in 30 percent of patients with chronic anterior blepharitis affecting the base of the lashes, but which is also found with approximately the same prevalence in asymptomatic people. […] A second species, Demodex brevis, has been associated with posterior blepharitis and occupies the meibomian glands. […] The altered tear-film integrity and the proliferation of these organisms lead to a generalized inflammation of the ocular surface. Long-term inflammation leads to gland dysfunction, hyper-keratinization and fibrosis, as well as damage to the eyelid and ocular surface.

• #1 CRSToday | Blepharitis and Demodex

  https://crstoday.com/articles/jan-2025/blepharitis-and-demodex

  D folliculorum resides in eyelash follicles and roots, where its claws mechanically irritate the follicular epithelium. This irritation induces epithelial hyperplasia around the lash base, leading to reactive hyperkeratinization. The accumulation of keratin and epithelial cells presents as cylindrical dandruff (CD). […] Unlike D folliculorum, D brevis inhabits the deeper regions of meibomian and sebaceous glands. The mites’ chitinous exoskeleton acts as a foreign body, eliciting granulomatous reactions within the meibomian glands. These reactions contribute to MGD and lipid tear insufficiency. […] Demodex contributes to DB through direct mechanical and inflammatory damage as well as by serving as a vector for bacteria. Although these hypotheses provide biologic plausibility, further studies are necessary to elucidate the exact pathologic mechanisms underlying DB.

• #1 The Role of Biofilms in Pathology of the Ocular Surface – touchOPHTHALMOLOGY

  https://touchophthalmology.com/ocular-surface-disease/journal-articles/the-role-of-biofilms-in-pathology-of-the-ocular-surface/

  Newer classification schemes with respect to ocular surface disease (OSD) highlight the complexity of pathology and illuminate areas of potential scientific interest. […] One critical aspect of blepharitis is the formation of bacterial biofilms. […] Their role in the development of OSD, including dry eye and blepharitis, is only now being elucidated. […] Recent interest in a biofilm theory of dry eye disease as the natural sequelae of decades of chronic blepharitis highlights the attention the role of biofilm in OSD has garnered. […] Biofilms are typically found at the junction of mucous membranes, and it has been suggested that biofilm builds up year after year, until the bioburden results in vast over-colonization and eventual pathology in the form of blepharitis and even dry eye.

• #1 A Guide to Managing Blepharitis – Modern Optometry

  https://modernod.com/articles/2020-july-aug/a-guide-to-managing-blepharitis

  Blepharitis is an inflammatory condition of the eyelid that can cause redness, itching, and dandruff-like scales on the lashes. […] The International Workshop on Meibomian Gland Dysfunction described posterior blepharitis as an inflammatory condition of the posterior lid margin, of which MGD is one possible cause. MGD can originate from anterior blepharitis and underlying systemic inflammatory conditions such as rosacea. Chronic lid inflammation leads to terminal duct obstruction and changes or reduction in meibomian secretion. […] Nattis et al reported that bacterial biofilm can release virulent factors (eg, cytolytic toxins, proteases, and lipases) capable of destroying host tissue, which can cause escalating levels of inflammation not only of the lid margin, but also of the ocular surface.

• #1 Is blepharitis the progenitor of OSD? | Ophthalmology Management

  https://ophthalmologymanagement.com/issues/2018/october/is-blepharitis-the-progenitor-of-osd/

  A new theory suggests that blepharitis, MGD and DED are connected by a single concept: bacterial biofilm formation. […] A new theory suggests that these diseases are all connected by a single concept, bacterial biofilm formation, and that a new term, dry eye blepharitis syndrome (DEBS), would be a more accurate and appropriate terminology. The term explains the relationship between bacterial biofilm formation on the eyelid margin and connects blepharitis, MGD and dry eye as linear changes related to biofilm maturation and migration. […] Once the bacterial colony senses that its numbers have reached critical mass though an increased concentration of HSLs, quorum-sensing gene activation (QSGA) occurs. This happens when the bacterial population reaches a certain quorum, triggering dormant genes to activate. The newly activated genes now begin expressing inflammatory virulence factors, such as lipases, proteases and cytolytic toxins, among a host of others.

• #1 Is blepharitis the progenitor of OSD? | Ophthalmology Management

  https://ophthalmologymanagement.com/issues/2018/october/is-blepharitis-the-progenitor-of-osd/

  It is important to realize that not all strains of Staphylococcus are identical. Some are much more pathogenic than others. Some may create an early mature biofilm together with highly inflammatory toxins, producing severe blepharitis and chalazion in an 8-year-old. […] How does the biofilm affect the ocular surface? Stage 1 of DEBS starts with a folliculitis, or inflammation and edema of the lash follicles. […] In Stage 2, the biofilm continues to grow and DEBS impacts the MGs, leading to inflammation. […] As the thickened meibofilm accumulates within the MG, the gland eventually reaches capacity. It may leak through the wall of the gland, causing a chalazion. This is a critical point in the pathogenesis of chalazia and explains why the most effective therapy is not incision and drainage or intralesional steroids but is conservative therapy.

• #1 Is blepharitis the progenitor of OSD? | Ophthalmology Management

  https://ophthalmologymanagement.com/issues/2018/october/is-blepharitis-the-progenitor-of-osd/

  In Stage 3 of DEBS, the continued march of the biofilm leads to inflammation of the accessory lacrimal glands of Krause and Wolfring. […] Lastly, inflammation keeps happening and eventually weakens the structure of the tarsus, leading to ectropion, entropion and floppy eyelid syndrome. All of these changes are a result of biofilm progression.

• #1 Current Findings on Blepharitis | Contact Lens Spectrum

  https://www.clspectrum.com/issues/2010/july/current-findings-on-blepharitis/

  Changes in these components can easily affect the melting point of the secretion, which will act to reduce meibum delivery and lead to meibomian gland occlusion. […] As in anterior blepharitis, bacterial colonization can also have an effect in the development of posterior blepharitis by modifying the lipids secreted from the meibomian glands. […] These lipases are thought to break down triglycerides into monoand diglycerides, which have a higher melting point and thus will result in a lipid product that is more solid in nature. […] One of the target organs for androgens is the meibomian gland. […] Increased age is commonly associated with decreased meibum production, along with significant changes in meibomian gland orifice appearance.

• #1 A Guide for Breaking Down Blepharitis

  https://www.reviewofophthalmology.com/article/a-guide-for-breaking-down-blepharitis

  Blepharitis is characterized by long-term, repeated episodes of acute flare-ups, and it is commonly accepted that it is an inflammation of the eyelid margin, which involves the lid and its dermis, eyelashes, tarsal conjunctiva, mucocutaneous junction and the meibomian glands. […] Scholars have long expressed frustration with the disease’s pathogenesis; ophthalmologist Phillips Thygeson noted in 1946 that textbook discussions of blepharitis have long seemed to me to be regrettably inadequate with respect to both etiology and therapy. […] A number of possible causes for blepharitis have emerged, including bacterial components such as Staphylococcus aureus, Staphylococcus epidermidis, Propionibacterium acnes and Corynebacteria sp.; rosacea, seborrheic dermatitis, microscopic mites (demodex folliculorum), lipophilic yeast found in cutaneous flora such as Pityrosporum ovale; contact allergy and androgen deficiency.

• #1 Blepharitis: types, presentation, and treatment – EyeWorld

  https://www.eyeworld.org/2023/blepharitis-types-presentation-and-treatment/

  According to Vincent de Luise, MD, blepharitis is one of the most common conditions seen by ophthalmologists. This inflammation of the eyelid margins can be acute or chronic and has a multitude of etiologies, including allergic, infectious, immune, systemic, and neoplastic causes. […] He thought they all come from bacteria forming biofilm, he said. Bacteria colonization starts to affect everyone between 24 years old. These bacteria continue to increase during ones lifetime and form biofilms on the eyelid margins that slowly progress. […] The bacterial biofilm continues to migrate into meibomian glands, which leads to meibomian gland dysfunction. Later in life, it reaches into the accessory lacrimal glands and leads to dry eye syndrome (aqueous deficiency). […] Dr. de Luise said that anterior blepharitis due to staphylococcal organisms and posterior blepharitis due to meibomian gland dysfunction are among the most common forms.

• #1 Blepharitis and Stress | Centers for Dry Eyes

  https://www.centersfordryeye.com/blog/blepharitis-and-stress?p=a6B5byyWazScPArbX

  Blepharitis is a common, chronic inflammation of the eyelids, usually caused by the malfunctioning of the oil glands in the eyelids known as meibomian glands. This condition can lead to irritation, redness, swelling, and a burning sensation in the eyes. […] Stress affects almost every part of the body, and yes, it can make your blepharitis worse. Studies have shown that psychological stress can trigger inflammation and weaken the immune system, making the body more vulnerable to chronic conditions, including blepharitis. High-stress levels can exacerbate the symptoms of dry eye, and eyelid irritation, and increase the likelihood of flare-ups. […] While stress alone isn’t typically the direct cause of blepharitis, it can worsen the condition. Stress can lead to poor sleep, weakened immune systems, and increased inflammation, all of which contribute to eyelid issues. When stress disrupts the body’s natural functions, conditions like meibomian gland dysfunction can become more difficult to manage, causing recurring or worsened symptoms.

• #1 CRSToday | The Incidence and Impact of Blepharitis on Cataract Surgery

  https://crstoday.com/articles/2009-may/crst0509_14-php

  Anterior and posterior blepharitis has often been considered a nuisance rather than a serious medical problem. […] As our understanding of the condition grows, however, it is becoming apparent that blepharitis is more than an annoyance. […] Some of the sequelae include common chalazion or internal hordeolum, dry eyes, punctate keratitis, phlyctenular or pannus formation, corneal ulceration, and most dramatically, endophthalmitis. […] Posterior blepharitis is primarily a disorder of the meibomian glands. […] The meibum becomes altered, and long-chain fatty acids change to free fatty acids, which combine with inflammation and cause saponification or soap formation, which is accentuated by the action of bacterial lipases. […] This action further degrades the fatty portion of the tear film and affects the meibum in the glands. […] If all of this is left unchecked, evaporative loss increases significantly, resulting in a recalcitrant inferior superficial punctate keratitis. […] Understanding the pathophysiology of blepharitis is helpful in framing treatment plans to care for our patients.

• #1 Blepharitis (Eyelid Inflammation): Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10032-blepharitis

  Blepharitis means inflammation of the eyelid. The edges of your lids turn red or dark in color and become swollen and scaly. Blepharitis usually affects both eyes. It can happen when a skin condition causes irritation, when you develop an infection or when oil glands become clogged. All of these things can even happen at once. […] Blepharitis can happen if you have issues with the meibomian glands that produce the oils found in tears, certain skin conditions or infections. […] Meibomian gland dysfunction (MGD): When the oil from meibomian glands doesn’t flow freely, you can develop dry eye, which can result in inflammation and infection. […] Its important to treat root causes that trigger blepharitis, in addition to soothing symptoms. Skin conditions (such as rosacea) or eye ailments (such as dry eye) can lead to blepharitis recurring more often. In these cases, certain pills, skin creams, or eye drops for dry eyes may help. […] You can’t cure blepharitis. However, it can be treated and controlled through proper eyelid hygiene. Left untreated, blepharitis may lead to other more serious eye conditions, including corneal problems, which may be significant.

• #1 A Guide to Managing Blepharitis – Modern Optometry

  https://modernod.com/articles/2020-july-aug/a-guide-to-managing-blepharitis

  MGD leads to OSD by causing tear hyperosmolarity, increased evaporation of tear film, and inflammation. […] When inflammation is present on examination, I prescribe at least 1 month of doxycycline, 100 mg to 200 mg per day, and/or a topical antibiotic or combination antibiotic and steroid. I believe inflammation will persist until debris and biofilm are eliminated. […] Hypochlorous acid has also been found effective at reducing Demodex mites. […] Blepharitis that is undertreated or untreated can lead to permanent disfigurement of the lids, conjunctiva, and corneas. Lid disfigurement from chronic inflammation can include lid notching, chronic trichiasis, ectropion, entropion, chalazion, and has been associated with lagophthalmos.

• #1 Uncommon Blepharitis

  https://www.mdpi.com/2077-0383/13/3/710

  Blepharitis is a common chronic inflammatory condition affecting the eyelid margins; the pathophysiology of blepharitis is complex and not fully understood. […] The pathophysiology of blepharitis is complex and not fully understood. It is believed to be a multifactorial disease with various underlying causes. […] Anterior blepharitis is also associated with seborrheic dermatitis. […] The process through which bacteria induce the symptoms of blepharitis is not completely comprehended. It might involve direct irritation caused by bacterial toxins and/or an increased immune response against S. aureus. […] Posterior blepharitis, on the other hand, is caused by dysfunction of the meibomian glands, which secrete lipids that form the outer layer of the tear film. Dysfunction of the meibomian glands can lead to alterations in the lipid composition of the tear film, resulting in evaporative dry eye and inflammation of the eyelid margins.

• #1 Uncommon Blepharitis

  https://www.mdpi.com/2077-0383/13/3/710

  The exact mechanism of bortezomib-induced blepharitis is not well understood, but it is thought to be related to the drug’s effect on the meibomian glands. There is a hypothesis that bortezomib could hinder the ubiquitin pathway, resulting in the accumulation of proapoptotic molecules in the meibomian gland. This, in turn, could cause blepharitis and recurrent chalazia as secondary effects. […] The mechanism by which cetuximab causes blepharitis is not fully understood, but it is thought to be related to the drug’s effects on the epidermal growth factor receptor (EGFR) signaling pathway. […] The exact mechanism by which TNF-α inhibitors cause blepharitis remains unclear, but it has been suggested that it may be a paradoxical reaction thought to be secondary to genetic susceptibility, dominance of helper T cells types 1 and 17, and excessive immune response from interferon-α overproduction by plasmacytoid dendritic cells. […] The mechanism by which dupilumab causes blepharitis is not fully understood, but it has been suggested that it may be related to the drug’s effects on the immune system and the ocular surface. […] This will enable the development of more effective etiological therapies in the future.

• #1 ▷ Blepharitis | What it is, symptoms and treatment – Barraquer

  https://www.barraquer.com/en/pathology/blepharitis

  Blepharitis can be anterior, which is when it affects the base of the eyelashes, or posterior, which is when it affects the Meibomian glands. […] Posterior blepharitis involves the Meibomian glands, which secrete fats. Fats play a very important role in the homeostasis of tears. Therefore, when there a dysfunction of the Meibomian glands either due to a blocked gland pore or atrophy, evaporative dry eye may occur. […] Treatment must be individualised and aimed at the cause of the disease. […] In terms of posterior blepharitis, treatment is usually tepid compresses and eyelid massages. In some cases, the specialist may offer intense pulsed light therapy (IPLT) for cases that do not respond to conventional treatment.

• #2 Blepharitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK459305/?report=printable

  The exact pathophysiology of blepharitis remains unclear but is likely multifactorial. Contributing factors include chronic low-grade bacterial infections of the ocular surface, inflammatory skin conditions such as atopy and seborrhea, and parasitic infestations with Demodex mites. Inflammation, bacterial colonization, and glandular dysfunction intricately interact in the pathophysiology of blepharitis, leading to tear film breakdown and persistent ocular surface discomfort. […] Although the 2 main types of blepharitis, anterior and posterior, involve somewhat different underlying mechanisms, they share inflammatory pathways that ultimately result in symptoms that are identical. In anterior blepharitis, the eyelid margin is directly colonized by bacteria, commonly Staphylococcus species. These bacteria release toxins and enzymes, such as lipase, that break down lipids, producing cytotoxic and pro-inflammatory free fatty acids. These fatty acids destabilize the tear film’s lipid layer. Prolonged exposure to these free fatty acids can lead to corneal damage in addition to causing discomfort.

• #2 Blepharitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/18370

  Blepharitis has a complex etiology involving bacterial infections, skin disorders, gland dysfunction, and occasionally parasitic invasion. One of the most well-established contributing factors is the presence of bacteria, particularly Staphylococcus species, on the eyelid margin. […] The exact pathophysiology of blepharitis remains unclear but is likely multifactorial. Contributing factors include chronic low-grade bacterial infections of the ocular surface, inflammatory skin conditions such as atopy and seborrhea, and parasitic infestations with Demodex mites. Inflammation, bacterial colonization, and glandular dysfunction intricately interact in the pathophysiology of blepharitis, leading to tear film breakdown and persistent ocular surface discomfort. […] Although the 2 main types of blepharitis, anterior and posterior, involve somewhat different underlying mechanisms, they share inflammatory pathways that ultimately result in symptoms that are identical. In anterior blepharitis, the eyelid margin is directly colonized by bacteria, commonly Staphylococcus species. These bacteria release toxins and enzymes, such as lipase, that break down lipids, producing cytotoxic and pro-inflammatory free fatty acids. These fatty acids destabilize the tear film’s lipid layer. Prolonged exposure to these free fatty acids can lead to corneal damage in addition to causing discomfort.

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