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Blepharitis in Cats

Inflammation of the outer skin and middle (muscle, connective tissue, and glands) portions of the eyelids is medically referred to as blepharitis. This condition is also usually seen with the secondary inflammation of the inner surface of the eyelid (palpebral conjunctiva).

Symptoms and Types

• Scaly, flaky skin near the eye
• Intense itching, scratching of the eye
• Watery, mucous or pus containing eye discharge
• Edema and thickening of the eyelids
• Abraded area(s) where the skin is torn or worn off (excoriation)
• Loss of hair
• Loss of skin pigmentation around affected area
• Papule formation (a small inflamed elevation of skin without pus)
• Pustule formation (a small inflamed elevation of skin with pus in it)
• Concurrent conjunctivitis (inflammation of conjunctiva of the eye)
• Inflammation of the cornea causing watery painful eyes and blurred vision (keratitis)

Causes

Congenital (born with)  

• Eyelid abnormalities which may promote excessive rubbing, scratching, or moist dermatitis
• Prominent nasal folds, trichiasis, and entropion (often seen in Persian and Himalyan cats)
• Ectopic cilia
• Inability to completely close the eyelids, or lagophthalmos (often seen in cat breed with short snouts or flat faces; i.e., Persian, Himalayan, Burmese cats)

Allergic 

• Type I (immediate) — due to adverse food, inhalant, or insect bite reaction
• Type II (cytotoxic) — pemphigus; pemphigoid; adverse drug reaction
• Type III (immune complex) — systemic lupus erythematosus; Staphylococcus hypersensitivity; adverse drug reaction
• Type IV (cell mediated) — contact and flea bite hypersensitivity; adverse drug reaction

Bacterial 

• Staphylococcus
• Streptococcus

Neoplastic 

• Sebaceous adenomas and adenocarcinomas
• Squamous cell carcinoma (white cats)
• Mast cell

Other 

• Traumatic injuries such as eyelid lacerations or chemical burns
• Parasitic infections (e.g., demodicosis, sarcoptic mange, Cuterbra)
• Viral infections (FHV-1)
• Eye diseases (e.g., conjunctivitis, keratitis, dry eye)
• Idiopathic (cause unknown)

Diagnosis

You will need to give your veterinarian a thorough history of the cat’s health, including the onset and nature of the symptoms and possible incidents that might have precipitated this condition. He or she will then perform a complete physical examination as well as a biochemistry profile, urinalysis, and complete blood count. Although their results are typically non-specific, they may reveal valuable information if a systemic disease is present. In particular, an eye exam may help determine the severity of the condition and the degree of involvement of the eye.

Your veterinarian may collect sample from the affected ocular area (or surrounding skin) to identify the causative microorganism, if present. These samples can be cultured to grow the bacteria, parasites, or fungus. A Schirmer tear test is also frequently conducted to determine whether the eye produces enough tears to keep it moist or not. And if a food allergy is suspected to be the cause, further testing may be required to identify the food allergen.