Which statement about blepharitis is NOT true?

Which statement about blepharitis is NOT true?

• A. The two main types are staphylococcal and seborrheic
• B. Staph blepharitis can only cause anterior blepharitis
• C. Seborrheic blepharitis is associated with a more oily, greasy looking appearance
• D. Seborrheic blepharitis is more associated with madarosis compared to staph blepharitis

Answer: (B)

Blepharitis presents on the eyelid margin in two broad patterns: anterior blepharitis, affecting the lash line, and posterior blepharitis, linked to Meibomian gland dysfunction. Staphylococcus aureus is a common culprit in anterior blepharitis, often described as staphylococcal blepharitis, and seborrheic dermatitis is another anterior cause. But staphylococcal involvement isn’t necessarily confined to the anterior lid margin. In many patients, eyelid inflammation shows mixed features or coexists with Meibomian gland dysfunction, so staphylococcal colonization can be seen in contexts that resemble posterior blepharitis as well, or in cases with concomitant posterior involvement. Saying that staph blepharitis can only cause anterior blepharitis overlooks these clinically observed overlaps, making that statement not true.

Contextual note: the oily, greasy appearance is characteristic of seborrheic involvement, which helps distinguish it from the staphylococcal anterior form, and madarosis is commonly discussed as a feature that can be more prominent with seborrheic blepharitis due to chronic inflammatory effect on the lashes.