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G. Venturino, G. Bricola, A. Bagnis, C.E. Traverso; Chronic Blepharitis: Treatment Patterns and Prevalence . Invest. Ophthalmol. Vis. Sci. 2003;44(13):774.
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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.
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