Blepharitis

[Image]Blepharitis (blef-ar-eye-tiss) is chronic inflammation of the eyelids that causes irritation, itching, and occasionally a red eye. The eyelids are composed of skin on the outside and mucous membranes on the inside. A cartilage-like plate, muscles, and glands are sandwiched in between. Blepharitis can begin in early childhood producing granulated eyelids, and may continue throughout life as a chronic condition or it may develop later in life. It can appear in one of two ways:

Seborrheic blepharitis is characterized by redness of the lids, scales and flaking around the eyelashes. It is often associated with dandruff of the scalp.

Ulcerative blepharitis is usually a more sever condition caused by bacteria and is characterized by matted hard crusts around the eyelashes which upon removal leave small ulcers that may bleed or ooze. The white part of the eye may turn red. In severe cases, the cornea (the clear front window of the eye) may become inflamed.

Blepharitis is usually associated with a skin type that is releated to a family of inflammations like eczema, allergies, and acne roscea.  Blepharitis comes in fits and spurts; it may not cause any symptoms at times and may be very symptomatic other times.  Many patients think they have eye allergies that come and go when in fact it is the blepharitis that is coming and going.  There may be loss of eyelashes and distortion of the eyelid margins, which can lead to chronic tearing.

What are the Symptoms?

Commonly the eyelid margins are red, with scales and flakes apparent at the base of the eyelashes. There may be irritation and the sensation of a foreign body in the eye, with redness, burning and itching of the eyelid margin. On awakening in the morning, the eyelids may feel stuck with crusted scales and debris caused by an oily discharge from the eyelid glands. Untreated, these glands may become plugged and infected, potentially leading to recurrent styes, dry eye syndrome, and a loss of lashes.

How Is Blepharitis Treated?

In view of the long-term nature of the condition, strict lid hygiene is necessary. The following regimen may be useful:

  1. Fill a small glass with warm water.
  2. Add three drops of baby shampoo.
  3. Take a clean cotton ball and soak it in the solution.
  4. While the eyes are closed, gently scrub both eyelids for two minutes .
  5. Rinse with cool tap water.
  6. Gently dry with a clean towel.
  7. Use medications as directed.

There is a product called LID-CARE that is a pre-mositened towelette that can be wrapped around your finger and used to scrub the upper and lower lids along the base of the lashes several times.  Care should be taken not to rub inside the eye.  Warm compresses used before LID-CARE can help soften and loosen the debris on the lashes allowing easier removal with LID-CARE.  This is best accomplished using a clean wash cloth soaked in warm water held on the eyelids for 10 minutes without pressing on the eye.  Re-warm the cloth as necessary. 

Treatment of oily scalp with antidandruff shampoos may also be helpful.