Blepharitis

Introduction

Blepharitis is a relatively common inflammatory condition affecting the eyelid margin. It can affect the roots of the eyelashes (also known as anterior blepharitis) and the area immediately behind the eyelashes (also known as posterior blepharitis).

Etiology

In most patients, the cause is unknown.

In “anterior blepharitis” excessive bacterial activity may play a role. “Posterior blepharitis” is most common in patients with dermal conditions such as seborrheic dermatitis and rosacea (which causes redness of the skin at the cheeks and nose).

Clinical symptoms:

  • Redness and itching of the eyelids
  • Irritation and dry eye symptoms
  • Excessive tearing
  • Cyst formation within the eyelids
  • Loss of eyelashes and notches of the eyelid margin

Is blepharitis a life-long condition?

No. The disorder tends to wax and wine and in most patients, it does not tend to last – in its severe form- for more than a few months.

What are the factors that cause blepharitis to worsen?

Blepharitis tends to worsen in cold, windy weather and air-conditioned environments as well as due to prolonged computer usage, sleep deprivation and use of contact lenses. Moreover, it tends to be worse in the presence of an active skin disease, for instance rosacea and seborrheic dermatitis.

Treatment

Thorough hygiene of the eyelids is the basis for treatment and should take place twice a day for the first 2-3 weeks and then at least once a day for life to keep the inflammation under control.

There are three steps involved in the effective hygiene of the lids:

  • Application of heat
  • Massage
  • Cleanliness

 

Application of heat

The heat is applied to the eyelids for 5 minutes:
It helps to soften the skin and the crusts that are attached to the eyelids/eyelashes and to liquefy the clogged meibomian glands.

Massage

Massage the eyelids with your index finger right after applying heat.
Massaging helps to push the oily fluid out of the meibomian glands, thus helping stabilize the tear film on the surface of the eye.

Cleanliness

After the application of heat and massaging, clean the eyelids. The use of special wipes twice a day for 1 or 2 weeks is an excellent way to quickly control the condition.

Topical antibiotic preparations

In severe blepharitis, a topical antibiotic can be applied to the lid margin, after performing lid hygiene for a period of 2 weeks.

Oral antibiotics

Sometimes if posterior blepharitis cannot be controlled using the topical treatment described above, it is worth considering a 6-12-week course of oral dexycycline.