Blepharitis Ciliaris

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By Shandong Science And Technology Press (1985)

Blepharitis ciliaris is a very common subacute or chronic inflammation of the lid margin. Its pathogenesis is general weakness, infection of bacteria or stimulation by discharge due to chronic conjunctivitis.Symptoms and Signs

It occurs in the following three types:

  1. Ulcerative blepharitis: congestion, swelling and scales at the base of lashes. Ulcers may be presented when scales removed. Lashes may be glued together and easily lost but they are not replaced. Painful sensation, photophobia and lacrimation often associated.
  2. Scaly blepharitis: congestion of lid margin. There are whitish scales in the bases of the lashes, which are easily lost but not replaced.
  3. Canthal blepharitis: the inflammatory reaction usually occurs in the canthal margin of the lid, marked local congestion, ulceration and itching sensation present.

Blepharitis usually caused by diplococci of Morax-Axenfeld.

Treatment

A Points: Ermen and Hegu are the primary points. In the case of upper lid, Yuyao, Zanzhu, Sizhukong are associated. Yingxiang is associated for blepharitis of lower lid. Tongziliao is associated for lateral canthal blepharitis and Jingming for medical canthal blepharitis.

B Procedure: Ermen, perpendicular penetration performed 0.5 ~ 1 inch in deep with scraping the needle. Hegu, penetrated toward the Laogong. For all above points, retain the needle 5 ~ 10 minutes and manipulate once every 5 ~ 10 minutes. All associated points, except Jingming, are stirred up with three-edged needle till bleeding. Those are given once every other day.

Method of puncturing Jingming seen for acute conjunctivitis.

C Case example

Patient Guo, female, 63 years old, a peasant.

Blepharitis of lower lids and right medial canthus for more than 10 years. The severity was various with times and recurred though frequent remedies given.

Patient worked tiredly in recent days and sleep was not enough, symptoms thus became severe. Redness of lid margin, photophobia, lacrimation and increase of discharge. There were many small ulcers on the base of lashes.

The diagnosis was ulcerative blepharitis, and the treatment given was puncturing Ermen and Hegu given once daily, retained the needle 30 minutes, manipulated the needle once every 10 minutes. Stirred up Yingxiang till bleeding, once every other day. Redness of lid margin and discharge fluid diminished after three punctures. Swelling of lids lost after 6 punctures, discharge much reduced but slight congestion of lid margin remained. Symptoms all lost after further 3 remedies given. Patient had attacks twice in following days and cured with same treatments as above. The therapeutic effect was well in after 3 years.

Remarks

Blepharitis is like “Jian Xuan Chi Lan” , “Lan Yan Bian” or “Hong Yan Bian”. It was described in ancient Chinese medical book: “Over fatigue may cause redness and ulceration due to fire. Alcoholism may cause those symptoms to become severe. Too much crying may cause suffering of fire and wind-heat appears”.

Author treated 7 cases of blepharitis with above prescription. The results were 3 cases symptoms lost and no recurrence in after 1 year. 2 cases markedly improved, with partial symptoms lost; 1 case slightly improved; treatment discontinued in 1 case against advice.

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