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© Asian Journal of Ophthalmology, 2018
Affiliations
Praveena Gupta
Wilmer Eye InstituteJohns Hopkins UniversityBaltimore, MD 21287
Laura Di Meglio
Wilmer Eye InstituteJohns Hopkins University Baltimore, MD 21287
Ashley Behrens
Wilmer Eye Institute
Johns Hopkins University
Baltimore MD21287
How to Cite
Bloody tears: a case of bilateral ulcerative blepharitis
Vol 16 No 2 (2018): Asian Journal of Ophthalmology
Submitted: Aug 14, 2016
Published: Nov 21, 2018
Abstract
Chronic blepharitis leading to bilateral ulceration is rare to encounter. A 49-year-old African American female presents with bloody tears, severe pain, and photophobia in both eyes. Clinical presentation called for ulceration on the upper lid margins with excavated wound which bled on gentle rubbing. A systemic health review in combination of the symptoms and clinical picture led to the diagnosis of severe ulcerative blepharitis. Immediate oral antibiotics were started along with topical antibiotic cream. Ulcerative blepharitis can be easily misdiagnosed with sebaceous cell carcinoma. The pathophysiology of ulcerative blepharitis points to synergy between infectious entity and inflammatory aetiology, with either bacterial or fungal microorganisms as the trigger agents. Almost all cases of ulcerative blepharitis should include a dermatological evaluation given there is a strong association between ulcerative blepharitis and atopic dermatitis.