Blepharitis
What is Blepharitis?
Blepharitis is one of the most common external eye disorders in the general population. It is an ongoing inflammation of the eyelids and/or an eyelid gland dysfunction which can result in irritation, foreign body sensation, redness, burning, itching, tearing, "red-rimmed" lid margins, and lid debris/crusting (especially upon waking). It is often a cause of or is associated with dry eye and ocular surface disease, conjunctivitis, recurrent styes, or a loss of eyelashes/chronic eyelid damage. The patient's symptoms are sometimes fairly severe and out of proportion to the clinical findings resulting in a relative underdiagnosis of this condition.
What are the Causes of Blepharitis?
There are different types of blepharitis which include the following:
Anterior Blepharitis: is usually due to a chronic staphylococcal (a bacteria) infection and/or a seborrhoeic gland dysfunction (often associated with dandruff and seborrhoeic dermatitis). It is usually mixed (due to both causes).
Meibomianitis (Posterior Blepharitis): is a dysfunction of the meibomian glands. These glands are responsible for secreting one of the oily components of the tear film. Meibomianitis can occur by itself or with anterior blepharitis.
How do you Treat/Manage Blepharitis?
Treatment can sometimes include the use of topical or oral antibiotics, frequent warm compresses (10-15 minutes, 2-4X/day), lid massages (2-4X/day), mechanical expression of the glands, and proper hygiene (washing hands/avoid rubbing the eyes). However, the mainstay of treatment and ongoing management of blepharitis is daily eyelid hygiene procedures (warm compresses and lid scrubs). In addition, treatment of associated conditions such as dry eye and ocular surface disease often require management such as the use of artificial tears.
Daily eyelid hygiene procedures (warm compresses and lid scrubs) are as follows:
- Warm Compresses: Use warm compresses for 5 to 15 minutes to soften and loosen any lid debris/crusting. This can be accomplished with a clean wash cloth soaked in warm water (as warm as can be comfortably tolerated) held to the eyelids. Re-soak the wash cloth as required.
- Lid Scrubs: Clean the lid margin and eyelid area using a commercially available over-the-counter eyelid hygiene product from the pharmacy (such as Lid-Care, Theratears Sterilid) (or less conveniently using diluted baby shampoo and a Q-tip/clean wash cloth). These products can be considered as "soap" for the eyelids. Do not clean the inner side of the eyelid or the eye itself. Instructions are usually provided with the commercially available products.
- Rinse: Using clean warm water, rinse the "soap" from the eyelids, and pat them dry.
- Note: Often initially this needs to be done twice a day. When the condition has improved, ongoing once daily procedures are often required. It is usually better to be done in the morning after waking.
Blepharitis is usually a chronic (ongoing) condition which can often persist throughout a lifetime. Fortunately, although not curable, appropriate treatment can usually adequately manage the signs and symptoms associated with this condition.