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What is Blepharitis?

Blepharitis is a common and persistent inflammation of the eyelids. Symptoms include irritation, itching, and occasionally, a red eye.

blepharitisThis condition frequently occurs in people who have oily skin, dandruff, or dry eyes. Blepharitis can begin in early childhood, producing “granulated eyelids,” and continue throughout life as a chronic condition, or develop later in life.

Bacteria reside on the surface of everyone’s skin, but in certain individuals they thrive in the skin at the base of the eyelashes. The resulting irritation, sometimes associated with over-activity of the nearby oil glands, causes dandruff-like scales and particles to form along the lashes and eyelid margin. In Blepharitis, both upper and lower eyelids become coated with oily debris and bacteria near the base of the eyelashes. The eye feels irritated and may become inflamed. Regular, thorough cleansing of the lid margin helps control Blepharitis.

Blepharitis occurs in two forms:

  • Anterior Blepharitis – affects the outside front of the eyelid where the lashes are attached. The two most common causes of anterior Blepharitis are bacteria (staphylococcus) and scalp dandruff.
  • Posterior Blepharitis – affects the inner eyelid (the moist part that makes contact with the eye) and is caused by problems with the oil glands (meibomian glands) in this part of the eyelid. Two skin disorders can cause this form of Blepharitis: acne rosacea, which leads to red and inflamed skin, and scalp dandruff (seborrheic dermatitis).

For some people the scales or bacteria associated with Blepharitis produce only minor irritation and itching, but in others they may cause redness, stinging or burning. Some people may develop an allergy to the scales or to the bacteria which surround them. This can lead to a more serious complication — inflammation of the eye tissues, particularly the cornea (the clear “front window” of the eye).

How is Blepharitis treated?

Dr. Maria states that Blepharitis can be a stubborn problem. Although there is no specific cure, it can be controlled through a careful, regular program of hygiene.

First, you should obtain the necessary equipment:

  • A concave or “cosmetic” mirror (available in most drug stores)
  • Cotton balls, a clean washcloth or commercial lint-free pads
  • Cotton-tipped applicators (“Q-tips”)
  • A mild baby shampoo, soap which doesn’t sting the eyes, or a commercial eyelid cleansing solution
  • A small, clean glass or jar.

The cleansing routine below should be followed at least twice a day at first; perhaps less often as the condition improves.

  1. Take a clean washcloth, wet it with warm to hot water, wring it out and place it over your closed eyelids for five minutes. This will help to soften the crusts and loosen the oily debris. Re-wet as necessary to maintain the desired temperature.
  2. If you are not using one of the ready- made eyelid cleansing solutions, prepare your own by filling the small glass or jar with 2 to 3 ounces of warm water and adding three drops of baby shampoo.
  3. Moisten a cotton ball, clean cloth or lint free pad in the solution and then gently scrub the eyelids for about two minutes. Your eyes should not be squeezed tightly shut, but closed softly as if you were sleeping.
  4. Looking into the magnifying mirror, gently use a Q-tip moistened in the cleansing solution to brush the scales away from the eyelids. You can brush either in a horizontal or vertical direction, as long as the granular debris trapped in the eyelashes is effectively loosened and removed. This procedure should take approximately half a minute for each eyelid.
  5. Thoroughly rinse your eyes with cool tap water and dry gently with a clean towel.
  6. Discard any cleansing solution left in the small glass and rinse it clean.
  7. If medication has been prescribed, it should be applied to the eyes and/or eyelids along the lashes, following your eye doctor’s instructions.

Will medication help?

Dr. Fava notes that many medications are available for the treatment of Blepharitis, and antibiotics, including antibiotics and steroid (cortisone) combinations in drop or ointment form. While cortisone medications often hasten relief of symptoms, long-term use can cause some harmful side effects such as glaucoma and progression of cataracts.

Once the acute phase of the condition is overcome – a process which may take several weeks, milder medications, if any, may be helpful to control your Blepharitis. However, medications alone are not sufficient; the daily cleansing routine described above is essential.

What about supplements?

Recently, some authorities have suggested using flax oil supplements (omega-3 fatty acid), either by pill or by liquid, to stabilize the meibomian secretions associated with meibomian seborrheic Blepharitis. Be sure to discuss any supplement use with your doctor.

Can I continue to wear my contact lenses?

Because Blepharitis tends to be chronic, expect to keep up the therapy for a prolonged period of time to keep it a bay. Depending on the type of Blepharitis you have, if you wear contact lenses, your doctor may want you to discontinue wearing them during the treatment period and even beyond. Some patients who wear soft contact lenses are prescribed RGP contacts instead. Others are urged to replace their soft lenses more frequently because of the potential for excessive deposit buildup. Some people simply don’t do well with contact lenses and will have to consider other options.

Can I still wear makeup?

Not wearing eye makeup, while the disease is more active, is also a good idea, since it can get in the way of eyelid hygiene and massage treatments. With some kinds of Blepharitis, it is recommended that you use an anti-dandruff shampoo for your scalp and eyebrows.

Why are regular medical eye examinations important for everyone?

Eye disease can occur at any age. Many eye diseases do not cause symptoms until damage has occurred. Since most blindness is preventable if diagnosed and treated early, regular medical examinations by an ophthalmologist are very important. Why an ophthalmologist? In short, an ophthalmologist (MD or osteopath) provides total eye care: medical, surgical and optical.

Our office provides comprehensive medical and surgical services as well as vision care, glasses, and contact lenses. Please feel free to recommend us to your friends and family.

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