McCulley J P, Dougherty J M, Deneau D G
Ophthalmology. 1982 Oct;89(10):1173-80. doi: 10.1016/s0161-6420(82)34669-2.
Since last thoroughly evaluated over three decades ago, the clinical spectrum of chronic blepharitis has changed. The relative prevalence of Staphylococcus aureus alone or in combination with seborrheic blepharitis has decreased. The relative prevalence has increased of seborrheic blepharitis with or without associated excess meibomian secretions (meibomian seborrhea) or inflammation (meibomitis). Primary meibomitis appears not to be a primarily infectious entity but to represent a facet of generalized sebaceous gland dysfunction and to be found in association with seborrheic dermatitis or acne rosacea. The keratoconjunctivitis found in association with primary meibomitis may be contributed to by the production of bacterial lypolytic exoenzymes that split neutral lipids, resulting in an increased level of free fatty acids in the tears. A frequent finding of keratoconjunctivitis sicca in this patient population, especially the S. aureus group (50%), is of note. Of particular importance is that these entities be recognized as chronic diseases requiring control and ones for which there is no "cure."
自从三十多年前上次进行全面评估以来，慢性睑缘炎的临床谱已发生变化。单独的金黄色葡萄球菌感染或与脂溢性睑缘炎合并感染的相对患病率有所下降。伴有或不伴有睑板腺分泌过多（睑板腺脂溢）或炎症（睑板炎）的脂溢性睑缘炎的相对患病率有所上升。原发性睑板炎似乎并非主要是一种感染性疾病，而是代表了全身性皮脂腺功能障碍的一个方面，并且常与脂溢性皮炎或酒渣鼻相关。与原发性睑板炎相关的角结膜炎可能是由分解中性脂质的细菌性脂解外酶的产生所致，导致泪液中游离脂肪酸水平升高。在该患者群体中，尤其是金黄色葡萄球菌感染组（50%），经常发现干眼症，这一点值得注意。特别重要的是，应将这些疾病视为需要控制的慢性疾病，并且不存在“治愈”方法。
