What is Blepharitis?
Belpharitis is characterised by an inflammation of the eyelid(s) resulting in a reddened, itchy, irritable and watery eye. It is not contagious.
Blepharitis generally presents when the meibomian glands which produce the secretion that forms the oily layer of the tear film don’t function properly.
The tear film consists of a mucus, a watery and an oily layer and a reduction in any of these three layers may produce an inadequate tear film. When the oily layer is reduced a ‘dry eye’ may result as the oily layer, apart from providing a smooth lubricated surface to the eye, also reduces tear evaporation.
This obstruction of the openings of the meibomian glands in the posterior/back edge of the lid margin can be caused by an eyelid infection or simply by the viscid nature of the secretions, which will be more viscous if the individual is relatively dehydrated.
Blepharitis can be caused by an infection with Staphylococcus bacteria, or as a complication of a skin condition, such as seborrhoeic dermatitis, a condition of flaking of the scalp (dandruff) or of the skin, including that of the lids, and also patients with acne rosacea – a condition that causes the skin to become oily or flaky or red and blotchy.
Who it Affects
It is a common condition; accounting for an estimated 1 in 20 eye problems reported to GPs. Blepharitis can develop at any age, but is more common in people over 40.
Symptoms range from watery eyes, to red eyes and red/swollen eyelids to crusting at the eyelid margins/base of the eyelashes to eyelid sticking or itching, flaking of skin on eyelids, a gritty/burning sensation in the eye, or foreign-body sensation, frequent blinking, light sensitivity, eyelash loss to infection of the eyelash follicle/sebaceous gland and dry eyes.
Among its other potential complications, blepharitis can lead to eyelid scarring if left untreated, chronic conjunctivitis, keratitis, and cornea ulcer or irritation. The symptoms and signs of blepharitis are often erroneously ascribed by the patient as being due to “recurrent conjunctivitis”.
The single most important treatment principle is a daily routine of lid margin hygiene, as described below. Self-care measures can for most people be the only treatment necessary. The standard and well-tried treatment of blepharitis is successful but requires discipline on the part of the patient.
The treatment requires the application of a hot compress: this is best done by dipping a flannel wrapped around the end of a wooden spoon into hot/boiling water and applying it, when no longer scalding, to the closed eyelids for two or three minutes.
After this application the eyelids should be cleaned using small cotton wool balls or cotton-tipped buds dipped in dilute baby shampoo (a few drops of shampoo in an egg cup of boiled water). Rub the cotton wool balls or cotton-tipped buds briskly along the lid margins to clear them of deposits which have resulted from the inflammatory process.
The process should be done twice daily for a week, then weekly thereafter. The treatment needs to be continued until the inflammation has resolved and may take a few weeks and re treatment is often necessary.
More severe cases e.g. microbial blepharitis may require antibiotics that are either applied to the eye or eyelid directly, or taken as tablets.
To prevent blepharitis remove eye makeup before going to bed. If you are in the early stages of treating blepharitis, avoid the use of eye makeup to prevent further irritation and replace your products used in or near the eyelids for new to prevent contamination.
A diet rich in good quality fresh raw fruits and vegetables will help provide the antioxidants necessary to neutralise the free radicals which cause the inflammation. Find out more.