Diagnosis and Tests for Blepharitis

Diagnosis and Tests for Blepharitis

Diagnosis and tests for blepharitis is generally straightforward and is usually based on a clinical eye examination and a review of symptoms. Most general practitioners, optometrists, or ophthalmologists can identify the condition without the need for complex tests.

Medical history:

• Your doctor will ask about:
  • The nature and duration of your symptoms
  • Triggers or environmental exposures
  • Existing skin conditions (rosacea, dandruff, eczema)
  • Use of cosmetics, eye drops, or contact lenses

Eye examination:

• The healthcare provider will use a slit lamp microscope to:
  • Examine the eyelid margins
  • Look for crusts, scales, swelling, or redness
  • Check for blocked meibomian glands
  • Assess the tear film quality and eye surface for signs of dryness

Tests that may be used in complex cases:

1. Eyelash sample
   • Doctors may remove a few eyelashes and examine them under a microscope to check for Demodex mites.
2. Tear breakup time
   • Doctors use this test to measure how quickly the tear film evaporates — a key step when they suspect dry eye syndrome
3. Tear film osmolarity
   • Measures the saltiness of tears, which can help assess inflammation and dryness.
4. Meibography
   • Imaging technique to visualise the structure and function of meibomian glands.

These specialised tests are generally available in ophthalmology clinics or advanced optometry practices in major cities like Cape Town, Johannesburg, and Durban. In rural areas, most diagnoses rely on physical examination alone.

In many South African public clinics, diagnosis is based on visible eyelid signs and patient-reported symptoms. Doctors refer patients to an ophthalmologist if they notice signs of complications such as vision changes, eye pain, or swelling:

• Persistent redness or swelling
• Eye pain or vision changes
• Suspected stye or chalazion
• Corneal involvement

Diagnosis and Tests for Blepharitis

Early diagnosis and patient education can significantly improve outcomes and prevent long-term damage or recurrence.

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