Blepharitis

What is Blepharitis?

Blepharitis is chronic inflammation of the margins of the eyelids. It can involve the eyelids,the eyelashes, the conjunctiva (whites of the eye) and the meibomian glands (which lubricate the eye). What are the symptoms and signs? Generally there is a persistent and unsightly redness and scaliness of the skin on and around the eyelid margins.

Other problems may include:

  • Persistent soreness of the eyelids or eyes.
  • Greasy appearance of the eyelid margins.
  • Flakes of skin like dandruff.
  • Eyelashes that fall out.
  • Small ulcers on the eyelid.
  • Crusting and bleeding (if severe).
  • Irritation of the eye (from flakes).
  • Sensation of “something in the eye”.
  • Grittiness, burning, itching and dryness.
  • Discharge from the lids, causing lashes to glue together during sleep.
  • Sensitivity to light.
  • Swelling of the eyelids and conjunctiva.


What are the main causes or types of Blepharitis?

  • Seborrhoeic Blepharitis — associated with Seborrhoeic dermatitis.
  • Rosacea Blepharitis — associated with Rosacea of face.
  • Staphylococcus Blepharitis — due to infection with the bacteria Staphylococcus aureus.


What are the complications of Blepharitis?

Apart from infection with staphylococcus, any of the following can occur:

  • Styes (infection of an eyelash).
  • Meibomian cyst infection.
  • Conjunctivitis.
  • Ulceration of the conjunctiva (whites of eye) or cornea (clear covering of eye).
  • Loss of eyelashes.
  • Scarring of eyelids.
  • Misdirected eyelash growth, e.g., inwards.


What is the expected outcome of Blepharitis?

Blepharitis is a chronic inflammation which is stubbornly resistant to treatment. It can be controlled rather than cured but tends to recur.

 

What is the treatment for Blepharitis?

  • Eyelid hygiene: this is the key to successful treatment. The crusts and other debris on the eyelids should be gently cleaned with a cotton wool bud dipped in clean warm water or a weak solution of sodium bicarbonate (baking soda) or a 1 in 10 dilution of baby shampoo. This should be done once or twice daily depending on the severity. An alternative is to apply a warm water or saline soak with gauze for 20 minutes followed by a rest for 60 minutes.
  • Control scalp seborrhea with anti-dandruff shampoo.
  • Eye lubricants such as artificial tear preparations will relieve the symptoms of dry eyes.
  • Avoid wearing eye make-up while inflammation is present.
  • Discontinue wearing contact lenses until the problem has cleared.


Medication for Blepharitis

  • Short-term use of a cortisone eye ointment applied to the margins after washing will give relief but needs to be prescribed by your doctor.
  • Antibiotic ointment can be used on the lid margin when active infection is present.
  • Your doctor may find it necessary to prescribe a combined cortisone and antibiotic ointment.
  • Oral antibiotics may be prescribed in the presence of a lid abscess or associated.

 


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