Journal of Clinical and Experimental Ophthalmology
Open Access

Abstract

Prevalence and Severity of Blepharitis Symptoms and Signs amongst Patients with Age-Related Macular Degeneration

Xiang Q Werdich, Tiffany Ruez and Rishi P Singh

Purpose: It is recommended that prior to intravitreal injections, ophthalmologists identify and treat comorbidities that predispose a patient to endophthalmitis,. Therefore, in populations that frequently receive intravitreal injections, such as patients with age-related macular degeneration (AMD), it is important to know the prevalence of these comorbidities. Blepharitis is a disease that is known to predispose to endophthalmitis, however, little is known on the rates of blepharitis within the AMD patient population. The purpose of this study was to determine the prevalence and severity of blepharitis amongst patients with age-related macular degeneration (AMD).
Methods: This IRB approved study included 50 patients (21 male, 29 female, age 78.1 ± 8.48 years) with both dry (n=21) and wet (n=29) AMD. Five common ocular surface symptoms and four clinical signs associated with blepharitis were evaluated. They were scored (0-4) by a self-reported survey and a blinded investigator performing a clinical examination. To compare the prevalence and severity of the symptoms and signs, total symptom and total sign scores were calculated and then normalized to the same scale of 0-10. The severity of symptoms and signs were then categorized as normal (0), mild (0.1-3.3), moderate (3.4-6.6), severe (6.7-10).
Results: In this AMD patient population, 32% had a history of dry eye or blepharitis prior to examination and 26% had a history of rosacae. Self-reported patient surveys and blind investigator examinations both demonstrated similar high prevalence of blepharitis. 14%of total patients reported no symptoms, and 6% had no clinical signs of blepharitis. Most patients had mild to moderate disease. The incidences were 50% and 36% for mild grade, 32% and 50% for moderate grade, and only 4% and 8% for severe grade, for the symptoms and signs of blepharitis, respectively. Self reported symptom scores were generally lower than clinical examination scores.
Conclusions: Both the rate and severity of signs and symptoms of blepharitis are increased in the AMD patient population. Implications of these finding should be further studied in a larger series to determine its impact on endophthalmitis occurrence.