This is where inflammation of the eyelids (blepharitis) leads to keratitis involving the limbus. This is the area where the cornea (clear window of the eye) meets the conjunctiva. It is more common in people with rosacea or eczema involving the eyelids. The oil producing glands, mebomian glands may also be affected. Patients may have had no prior symptoms but some may describe dry, watery eyes. This is because the tear film components are affected.
The areas affected will stain with fluorescein around the limbus. Treatment is initially with antibiotic drops until the keratitis is sterile. Later steroid drops are added to reduce inflammation and promote healing.
In some cases with severe blepharitis, mebomian gland dysfunction or rosacea a course of doxycycline antibiotics are suggested for 3 months.
Lid hygiene is vital for treatment to work and to ensure it does not recur. This includes lid bathing, massage and lid cleansing.
Who to refer:
Please see Lothian GP and optometry ophthalmology referral pathway.
Urgency of the condition for details on how soon patients should receive an appointment.
Patients who present with a problem with their only seeing eye should be advised to see an optician/ophthalmologist for review.
How to refer:
We require a referral letter for EVERY patient.
The preferred referral process is via SCI Gateway. If sending/forwarding a referral via SCI gateway please include past medical history, allergies and medications
If you do not have access to fax or SCI Gateway e.g. if you have arranged an appointment out of hours please send a written referral letter with the patient to bring to their appointment.
Only if SCI Gateway is unavailable should a letter be typed or handwritten. Please write legibly and include your examination findings.
If you have arranged an appointment in the acute referral clinic and you are referring from within another hospital in Lothian please use TRAK to type the referral letter.
