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Cynthia Ishin Tung, James Reidy, Ruth Marie Mattern, Sangita P Patel; The role of blepharitis in the healing course of corneal ulcers. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1260.
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© 2017 Association for Research in Vision and Ophthalmology.
Blepharitis is a known risk factor for the development of infectious keratitis, but the relationship between blepharitis and the healing course of corneal ulcers has not been defined. We performed a retrospective clinical study to determine the time to re-epithelialization of corneal ulcers in the presence and absence of blepharitis. We hypothesized that the presence of blepharitis would prolong the time to re-epithelialization of corneal ulcers.
A retrospective chart review was performed for 23 corneal ulcer patients that were diagnosed and treated over a 3 and a half year period (December 2011 to June 2015) by three ophthalmologists at a university eye institute. Two groups were studied: one with presence of blepharitis (n=11) and one with absence of blepharitis (n=12) on clinical slit lamp exam. Inclusion criteria were ICD-9 diagnosis codes for corneal ulcers (370.0, 370.01, 370.03). Exclusion criteria included neurotrophic, viral, fungal, acanthamoebic ulcers, ulcers greater than 6mm in longest diameter on presentation, association with uveitis or endophthalmitis, and history of corneal surgery or significant ocular surface disease. Number of days were recorded from the first visit where corneal ulcer was noted to the first visit re-epithelialization was noted. Student's t-test and Pearson’s correlation coefficient were used for statistical analysis.
In the blepharitis group, time to re-epithelialization of the corneal ulcer was significantly longer (19.3±15.1 days), compared to the non-blepharitis group (7.3±4.6 days) (p=0.02). Median days to re-epithelialization were 13 and 6, respectively. In correlating time to re-epithelialization with age, the non-blepharitis group showed a weak positive correlation (R = +0.23), while the blepharitis group showed almost no correlation (R = +0.081).
We conclude that blepharitis may create an environment of ocular surface inflammation that significantly delays the healing of corneal ulcers.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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