Chronic, non-inflammatory eyelid margin thickening in children should prompt reconsideration of common diagnoses. This One Minute Ophthalmology case describes a 13-year-old girl with long-standing beaded, cauliflower-like eyelid margin lesions misdiagnosed as blepharitis and treated with topical antibiotics and steroids for several years. Detailed examination revealed classic moniliform blepharosis with associated posterior subcapsular cataracts, a consequence of prolonged steroid use.
Systemic evaluation uncovered hoarseness of voice and tongue fissures, and incision biopsy with PAS-positive hyaline deposition confirmed lipoid proteinosis (Urbach–Wiethe disease). The report highlights that lipoid proteinosis lacks inflammatory signs, does not respond to conventional blepharitis therapy, and requires histopathology for definitive diagnosis. Early recognition is critical to avoid…
