Adult Blepharitis Workup

Updated: Aug 17, 2023
  • Author: R Scott Lowery, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Laboratory Studies

In general, diagnostic tests do not typically need to be performed for suspected blepharitis. Research and other rare protocols may involve eyelid margin cultures, transillumination studies of the meibomian glands, digital-imaging techniques, conjunctival impression cytology, marginal biopsies, or even analysis of gland secretions.

Testing patients with blepharitis for tear insufficiency or nasolacrimal drainage problems is appropriate because these can be associated with blepharitis and can often complicate management.


Histologic Findings

Seborrheic dermatitis is characterized histologically by spongiosis, mild perivascular, lymphohistiocytic, mononuclear cellular infiltrates in the superficial dermis. Staphylococcal blepharitis is a chronic nongranulomatous inflammation, usually with neutrophils and, often, acanthosis or parakeratosis.


Imaging Studies

The LipiView (Tear Science) allows visualization of each individual meibomian gland in the everted inferior tarsal plate, permitting a semi-quantitative analysis of meibomian gland viability. This device can also measure incomplete blink rate and the thickness of the lipid oil tear layer in nanometers.

Similar images of the meibomian glands can also be obtained with the Keratograph 5M (Oculus).