(Also Called 'Eyelid Inflammation')
What is blepharitis?
Blepharitis is an inflammation of the eyelids, usually caused by an excess growth of bacteria that is ordinarily found on the skin, and occasionally caused by allergies. Almost everyone has some form of blepharitis. This condition frequently occurs in people who have a tendency towards oily skin, dandruff, or dry eyes. Bacteria reside on the surface of everyone's skin but in certain people, they thrive in the skin at the base of the eyelashes. Substances produced by the bacteria, sometimes associated with over activity of the nearby oil glands, causes dandruff-like particles and scales to form along the lashes and eyelid margins. Although caused by bacteria, the condition is NOT contagious and is NOT infectious conjunctivitis often termed"pink eye."
The meibomian glands are tube-like glands that open at the edge of the eyelid just inside the lashes. These glands produce an outer oil layer that coats our tears to prevent them from evaporating. Meibomian Gland Dysfunction (MGD) is a form of blepharitis where the oil glands produce a thicker more wax-like secretion. As a result, the glands become clogged and inflamed. With an insufficient oil layer, the tear layer evaporates more rapidly and the eyes can become dry.
The symptoms of blepharitis may vary from very minor to very severe. Blepharitis causes the eyelids to be reddened, itchy and somewhat swollen and scaly appearing at the base of the eyelashes. As scales become coarser, the surface of the eye becomes irritated and forms crusts, which may cause the lids to stick together when you wake up in the morning. If this crust falls into your eye, you may feel like you have"something in your eye" or experience a gritty sensation.
Blepharitis is sometimes referred to as"Ocular Rosacea", and is often found in people with a Rosacea skin type. Common symptoms of Rosacea include: redness of the facial skin; a tendency to blush with hot weather, alcohol or spicy foods; thickening of the skin overlying the nose; increased number of"spider vessels" and irritated and bloodshot eyes. The exact cause is unknown but often improves with blepharitis treatment techniques.
Eventually a blockage of the oil glands along the eyelid margins can lead to a stye, also known as a chalazion. In severe cases, the cornea, the transparent covering of the front of the eyeball, may also become inflamed and vision affected. Fortunately, blepharitis is relatively easy to treat. However, it is a chronic condition and needs to be taken care of on a daily basis.
How is blepharitis treated?
Blepharitis cannot be cured; however, it can be treated and controlled through proper eyelid hygiene. In addition to eliminating redness and soreness, treatment can prevent potential infection and scarring of the cornea. Our doctors will perform a complete eye examination to determine the most effective treatment.
If you have blepharitis, take the steps listed below to help treat and cleanse your eye:
- Take a clean washcloth and wet it in very warm water. Wring the washcloth and place it over the closed eyelids for 5 minutes. Re-wet as necessary to keep it warm. This will help to soften crusts and loosen oily debris. Do this twice a day.
- Next, place the warm, wet washcloth over the index finger and apply a diluted solution of 50% baby shampoo with warm water.
- Cleanse one eye at a time, closing the eye you are cleansing, and rubbing the washcloth or your finger over the eyelashes and lid margins several times using horizontal strokes.
- Rinse thoroughly with a clean, warm, wet washcloth. Pat dry.
- An alternative to baby shampoo is to use pre-medicated lid scrub pads (Ocusoft), available over the counter in the eye care/contact lens product section of any pharmacy or grocery store. With this pad, clean along the lash margin (both upper and lower lids) with the eye closed for 20 or 30 seconds. Rinse with warm tap water. Turn the pad over and clean the other eye. REPEAT nightly for two weeks, then every other night as part of your daily hygiene routine.
For certain types of blepharitis, antibiotics may be recommended. Typically, Doxycycline by mouth twice per day is prescribed for at least two months. Contrary to common belief, use of tetracycline-type antibiotics is not primarily to treat bacterial infection, but rather to provide thinning of oil gland secretions. They can have side effects such as sunlight sensitivity and stomach upset, and must be used carefully.
Dry eye frequently goes hand in hand with blepharitis. Dietary supplements of Fish Oil capsules may be taken daily to provide the recommended intake necessary to relieve dry eye from blepharitis. The recommended dosage is at least 3 grams per day. You may also need to use artificial tears 4-6 times per day.
In some cases, your doctor may prescribe eye drops or ointment to be used along with the daily cleansing regimen. To administer the antibiotic medication, stand in front of a mirror, and place a small drop of antibiotic (e.g. AzaSite) in lower conjunctival sac while pulling lid away from eye with other hand. Apply these medicines after the lid cleansing. If any excess medicine is present, gently rub this into the bases of the lashes. Do not refrigerate the antibiotic medicine after opening, and store the bottle upside-down.
In severe cases of blepharitis in which the meibomian glands are completely plugged with oil, new treatments are available to open the blocked glands. One new procedure we are very excited about is called Meibomian Gland Probing. Our physicians can use a microscope to insert a small probe into each individual gland, removing the obstruction. The process takes 10 to 15 minutes for each eye, and may be repeated if necessary. Typically this can provide a substantial and sudden relief of the symptoms.
How do I prevent blepharitis?
There are many everyday steps that you can take to prevent blepharitis. These include:
- Keeping your hands and face clean
- Avoiding rubbing your eyes with dirty fingers, a soiled handkerchief, etc.
- Removing all eye makeup before bedtime
- Wiping any excess tears or eye drops from your eyelashes
If you are in the early stages of treating blepharitis, avoid the use of eye makeup to prevent further irritation. Once you begin using makeup again, replace any liquid products because your old products may be contaminated.