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Blepharitis

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Question

Mom of a 16-year-old boy with CdLS reports that he has had sties with pink or bloodshot eyes for the last month on and off. She states that they have been noted two times before. Currently trying to rule out pink eye (which he has also had before, but looked different). No cases reported at school. Pediatrician did not see in person but called in an antibiotic script over the phone, which mom is hesitant to give until she is sure of the problem.

Is this related to CdLS? Any thoughts on what could be causing this? Can it be related to either blepharitis or ptosis?

Answer of our experts

Very related to CdLS. Blepharitis results in suboptimal flow of the glands in the eyelids. Sties are simply the complete blockage of individual glands. Any child with blepharitis is more likely to get sties. This is also likely causing the red eye as a secondary effect. Treat with baby shampoo eyelash scrubs. Antibiotics won't hurt (suggest erythromycin ointment as most appropriate and least harmful choice), but are unlikely to make a large contribution. This condition is not contagious. Over-the-counter, artificial "teardrops" may be useful for the red eyes until the blepharitis is under control. May take weeks if not months to resolve. Continue scrubs treatment even when no longer symptomatic.

AL / TK 7-13-10

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Recommendation(s)

The eyes and the visual system

R36
Surgical correction of ptosis should be considered if vision is significantly affected or if the individual is lifting their chin in attempt to see more clearly and it is affecting the individual’s ability to move around.
R37
Blepharitis in individuals with CdLS should be treated conservatively with lid hygiene. Nasolacrimal duct obstruction (blocked tear ducts) should be suspected if symptoms are not improved with lid hygiene.
R38
Vision should be regularly evaluated in all individuals with CdLS, especially in infancy and childhood. Problems with vision should be corrected early to prevent amblyopia (lazy eye), although children may have difficulty tolerating glasses or contact lenses.

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