Abstract
Abstract: :
Purpose: a) to determine the prevalence of chronic blepharitis in a large sample of patients with non-specific symptoms b) to determine the presentation and treatment patterns c) to analyze congruity of treatment Methods: Clinical and history data from 1148 consecutive patients seeking for an eye examination because of ocular discomfort or irritation were prospectively collected using a standard chart and a questionnaire. Eye examination, lid skin and lid margin characteristics, onset and duration of symptoms, ongoing treatment, prescribed treatment and clinical course data were collected and analyzed. Results: Mean age was 46 years (S.D. 21; min 3 max 96) years. The most common reasons to seek eye care were redness (56%), burning (43%), foreign body sensation (39%); the duration was > 3 months in 48%, without significant differences between groups. Signs included lid margin alterations (65%), lid skin changes (50%), and corneal changes (14%). The three most commonly diagnosed clinical conditions were posterior blepharitis - PB (24%), dry eye - DR (21%) and anterior blepharitis ? AB (12%). Meibomian gland disease was significantly more frequent in PB than in AB and DR. Treatment at the time of examination was graded for consistency with the diagnosis and clinical course; mismatches occurred in 54% of the cases. At the time of the examination, treatment was not appropriate and yielded to a worsening in up to 60% of the cases, depending on the diagnostic group. Overall 62% of patients felt they were stable, i.e. their condition did not respond to previous treatment. The most frequently misused treatment was topical vasoconstrictors Conclusions: Chronic blepharitis (AB and PB) was the most common diagnostic entities among patients with non specific symptoms and/or ocular discomfort. In a majority of cases symptoms duration was longer than 3 months; overall, treatment in use was not specific to the diagnosis and gave poor clinical results. A rational approach to patients? complaints and to objective findings was clearly lacking. Straightforward diagnostic definitions and treatment guidelines are needed in this area of clinical care and will be proposed.
Keywords: clinical (human) or epidemiologic studies: pre • clinical (human) or epidemiologic studies: tre