Inflammatory eyelid conditions in children. Part II: a cross-sectional study

BACKGROUND: Blepharitis is a chronic, usually bilateral, inflammatory condition of the eyelids, which affects the skin, eyelashes, and meibomian glands. According to the Federal State Statistics Service for 2023, blepharitis accounts for 14.4% of all primary diseases of the eye and adnexa in the adult population and 14.29% of cases in children. Children with blepharitis often develop secondary keratitis or corneal ulcer, which can later cause corneal opacity, neovascularization, or blindness and anisometropic or stimulus deprivation amblyopia. Therefore, clinical, etiological, and pathogenetic features of blepharitis in children warrant further studies to better understand the disease course, develop effective treatment algorithms, and improve its clinical outcomes.

AIM: This study aimed to analyze clinical, etiological, and pathogenetic features and therapeutic approaches in bacterial blepharitis in children.

METHODS: A single-center, retrospective (with an analysis of medical records), cross-sectional study was conducted. The study included data from patients who were followed-up in outpatient tertiary offices for the diagnosis and treatment of infectious and allergic ocular diseases at the Helmholtz National Medical Research Center of Eye Diseases between 2020 and 2024. The etiological, pathogenetic, clinical, and therapeutic features of bacterial blepharitis in children were evaluated. The results were analyzed using descriptive statistics. The results are presented as absolute and relative values.

RESULTS: The study included clinical data from 242 children aged 3 to 17 years with bacterial blepharitis. The most common form of bacterial blepharitis in children was found to be meibomitis (posterior blepharitis), diagnosed in 73.1% of cases. Anterior and angular blepharitis was observed in 19.8% and 7.1% of cases, respectively. Anterior blepharitis mainly manifested as hordeolum and ulcerative blepharitis associated with Staphylococcus aureus, S. epidermidis, and Streptococcus pyogenes infection. Posterior blepharitis was associated with dysfunction of the meibomian glands, microabscesses, and secondary dry eye syndrome. Angular blepharitis associated with Moraxella lacunata was chronic with frequent recurrences and clinical symptoms in the lateral canthi.

CONCLUSION: The described clinical features of anterior, posterior, and angular blepharitis support early diagnosis, allowing for timely antibacterial therapy to prevent chronical disease, recurrences, and complications and to maintain and/or restore visual acuity.