RAMSAY SIME DARBY HEALTHCARE COLLEGE

DIPLOMA IN MEDICAL ASSISSTANT

SEMESTER 6

INDIVIDUAL ASSIGNMENT

NAME:NORSHAHIDAH BINTI ZAINAL

STUDENT ID:SD012017-04-002565
LP:
SUBMIT DATE:
DEFINITION OF BLEPHARITIS

Blepharitis (blef-uh-RYE-tis) is inflammation of the eyelids. Blepharitis usually involves

the part of the eyelid where the eyelashes grow and affects both eyelids.

Blepharitis commonly occurs when tiny oil glands located near the base of the eyelashes
become clogged. This leads to irritated and red eyes. Several diseases and conditions can
cause blepharitis.

Blepharitis is often a chronic condition that is difficult to treat. Blepharitis can be

uncomfortable and may be unsightly. But it usually doesn't cause permanent damage to
your eyesight, and it's not contagious

SIGN AND
SYMPTOM
OF

BLEPHARITIS

 The main symptom is sore eyelids. Both eyes are usually affected.
 The eyes may feel gritty, itchy or as though they are burning.
 The eyelids may look inflamed or greasy.
 The eyes may become sticky with discharge. In particular, the eyelids may stick
together in the morning.
 Sometimes tiny flakes or scales appear on the eyelids, which look like small flakes
of dandruff. Crusts may develop at the base of eyelashes.
 One or more of the tiny glands of the eyelids (meibomian glands) may block and fill
with an oily fluid

CAUSES OF BLEPHARITIS

 Seborrheic dermatitis — dandruff of the scalp and eyebrows

 A bacterial infection
 Clogged or malfunctioning oil glands in your eyelids
 Rosacea — a skin condition characterized by facial redness
 Allergies, including allergic reactions to eye medications, contact lens solutions or
eye makeup
 Eyelash mites or lice

COMPLICATION OF BLEPHARITIS

 Eyelash problems. Blepharitis can cause your eyelashes to fall out or grow
abnormally (misdirected eyelashes).
 Eyelid skin problems. Scarring may occur on your eyelids in response to long-
term blepharitis. Or the eyelid edges may turn inward or outward.
 Excess tearing or dry eyes. Abnormal oily secretions and other debris shed from
the eyelids, such as flaking associated with dandruff, can accumulate in your tear
film the water, oil and mucus solution that forms tears. Abnormal tear film
interferes with the healthy lubrication of your eyelids. This can irritate your eyes
and cause symptoms of dry eyes or excess tearing.
 Difficulty wearing contact lenses. Because blepharitis can affect the amount of
lubrication in your eyes, wearing contact lenses may be uncomfortable.
 Stye. A sty eis an infection that develops near the base of the eyelashes. The result
is a painful lump on the edge (usually on the outside part) of your eyelid. A sty is
usually most visible on the surface of the eyelid.
  Chalazion. A chalazion occurs when there's a blockage in one of the small oil
glands at the margin of the eyelid, just behind the eyelashes. The gland can
become infected with bacteria, which causes a red, swollen eyelid. Unlike a sty, a
chalazion tends to be most prominent on the inside of the eyelid.
 Chronic pink eye. Blepharitis can lead to recurrent bouts of pink eye
(conjunctivitis).

TEST AND PROCEDURES

 Examining your eyelids. Your doctor will carefully examine your eyelids and
your eyes. He or she may use a special magnifying instrument during the
examination.
 Swabbing skin for testing. In certain cases, your doctor may use a swab to
collect a sample of the oil or crust that forms on your eyelid. This sample can be
analyzed for bacteria, fungi or evidence of an allergy.

TREATMENT OF BLEPHARITIS

Self-care measures, such as washing your eyes and using warm compresses, may be the
only treatment necessary for most cases of blepharitis. If that is not enough, your doctor
may suggest prescription treatments, including:

 Medications that fight infection. Antibiotics applied to the eyelid have been
shown to provide relief of symptoms and resolve bacterial infection of the eyelids.
These are available in a variety of forms, including eyedrops, creams and
ointments. If you don't respond to topical antibiotics, your doctor may suggest an
oral antibiotic.
 Medications to control inflammation. Steroid eyedrops or ointments may help
control inflammation. Your doctor may prescribe both antibiotic and anti-
inflammatory drugs.
 Medications that affect the immune system. Topical cyclosporine (Restasis) is a
calcineurin inhibitor that has been shown to offer relief of some signs and
symptoms of blepharitis.
  Treatments for underlying conditions. Blepharitis caused by seborrheic
dermatitis, rosacea or other diseases may be controlled by treating the underlying
disease.

HEALTH EDUCATION

Clean your eyes daily

 Apply a warm compress over your closed eye for several minutes to loosen the
crusty deposits on your eyelids.
 Immediately afterward, use a washcloth moistened with warm water and a few
drops of diluted baby shampoo to wash away any oily debris or scales at the base
of your eyelashes. Use a different clean cloth for each eye.
 In some cases, you may need to be more deliberate about cleaning the edge of
your eyelids where your eyelashes are located. To do this, gently pull your eyelid
away from your eye and use the washcloth to gently rub the base of the lashes.
This helps avoid damaging your cornea with the washcloth. Ask your doctor
whether you should use a topical antibiotic ointment after cleaning your eyelids in
this way.
 Rinse your eyelids with warm water and gently pat it dry with a clean, dry towel.
 Stop using eye makeup when your eyelids are inflamed.

Lubricate your eyes

Try over-the-counter artificial tears. These lubricating eyedrops may help relieve dry
eyes.

Control dandruff and mites

Using a dandruff-controlling shampoo may relieve blepharitis signs and symptoms. Using
tea tree shampoo on eyelids each day may help deal with mites. Or try gently scrubbing
lids once a week with a 50 percent tea tree oil, which is available over-the-counter.

PATIENT PARTICULAR

1.MEDICAL RECORD:

2.NAME:

3.GENDER:Female

4.AGE:25 yrs

5.ETHNIC:Malay

6.OCCUPATION:

7.DIAGNOSIS:

OBSERVATION RESULTS

02 Temperature:

03 Respiration rate:minutes

04 Blood pressure :mmHg

05 Pulse rate :bpm

06 Pulse rhythm:Normal
 07 Pulse volume:Good

CHIEF COMPLAINT

 B/E:Itching ,irritation,redness and sore eyelids x2/7

 B/E:Crusty eyelids with the loss of eyelashes

 B/E:Difficulty in opening of eyelids after waking up and worsens in the morning

associated with blur vission

 No history of headache

HISTORY OF PRESENT ILLNESS

PAST OCCULAR HISTORY

 No history of glasses
 No history of surgery eye

 No history of trauma

PAST MEDICAL HISTORY

PAST SURGICAL HISTORY

DRUG HISTORY

 Patients claim no allergy to food or medicines.

SOSIAL HISTORY:
 Active smoker
 Non alcoholic

 Student Diploma

PART 3: PHYSICAL EXAMINATION

VISUAL ACUITY TEST

RIGHT EYE:6/9

LEFT EYE:6/9

INTRAOCCULAR PRESSURE:

SLIT EYE EXAMINATION:

 Eyelashes(madarosis-absence/loss of the eyelashes,trichiasis-ingrowth of the

eyelashes)
 Conjunctiva normal

 Pupils normal

 Corneal erosion

 Anterior Chamber Depth normal

 Yellow crust

 Lens normal

I. Ophtalamic status
Right eye Left eye
Periocular appearance Normal Normal
General condition Well Well
Eyeball position Orthophoric Orthophoric
Eyeball movement Can move to 8 directions Can move to 8 directions
Visual acquity 5/40 5/30 (S+2.5)  5/5
Supercillia Full, symetric Full, symetric
Cilia Normal Normal
Sup/Inf Margo Palpebra Well-positioned Well-positioned
Sup/Inf Tarsal Hyperemic Hyperemic
Conjunctiva
Bulbar conjunctiva Normal Normal
Cornea
- Clearness Clear Clear
- Edema - -
- Infiltrate - -
- Ulcer - -
- Crust - -
- Destruction - -
Anterior Chamber Mild depth Mild depth
Clear Clear
Iris Darkish brown Darkish brown
 Crypt (+) Crypt (+)
Pupil Center Center
Round Round
 3mm  3mm
Light reflex (+)/(+) Light reflex (+)/(+)
Isochoric Isochoric
Lens Pseudophacia Cloudy (posterior
subcapsular)
Palpebra Hyperemic + Hyperemic +
edema + edema +
tenderness + tenderness +
nodule - nodule -

PART 5:DIAGNOSIS

PROVISIONAL DIAGNOSIS: :

DIFFERENTIAL DIAGNOSIS:

DIAGNOSIS:

PART 6:RELEVENT INVESTIGATION

PART 7:MANAGEMENT

EARLY MANAGEMENT MEDICATION NURSING CARE

PART 8:ADVICE TO PATIENT

Avoid rubbing of the eyes

Do warm compress for 5-10 minutes

SUMMARY

REFERENCES

1. https://www.slideshare.net/hmirzaeee/blepharitis
2. https://www.slideshare.net/AshishChaudhari13/case-reportblepharitis
3. https://www.mayoclinic.org/diseases-conditions/blepharitis/symptoms-
causes/syc-20370141
4. http://www.allaboutvision.com/conditions/blepharitis.htm
5. https://www.webmd.com/eye-health/blepharitis
6. https://patient.info/health/swollen-eyelid/blepharitis