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Blepharitis
Blepharitis
What is Blepharitis?
What is Blepharitis?
It’s an umbrella term for conditions that cause lid margin itching, swelling, redness, and crusting of the margin and the lashes.
What causes Blepharitis?
What causes Blepharitis?
Usually, it’s a combination of factors that brings in the condition and the combinations vary from patient to patient
Bacterial and Demodex related Anterior Blepharitis- Lid margin infection by resident bacteria results in the formation of crusts on lashes.
Seborrheic Anterior Blepharitis- Excessive meibomian secretions commonly associated with seborrheic dermatitis of the scalp resulting in flakes at the margin and on the lashes.
Posterior Blepharitis - Defective Meibomian Glands Secretion at the back of the lid margin results in thick toothpaste-like secretions and inflammations around the gland openings. This can be associated with Rosacea.
Why is Blepharitis important?
Why is Blepharitis important?
In addition to Blepharitis being an irritating condition both cosmetically and functionally, it also can produce complications like:
Dry Eyes
Chalazion / Hordeolum (Lid margin abscesses)
Cellulitis of Lids
Corneal Ulceration
Corneal Vascularization
How is Blepharitis treated?
How is Blepharitis treated?
Lid Hygiene
this is the cornerstone of controlling blepharitis and includes
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Using Warm Compresses to soften the oils.
Hold a hot flannel or microwavable eye bag firmly onto closed eyelids for 3 minutes to soften the oil in the glands. Take care not to burn your skin
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Massaging the lid margin to unblock the blocked glands
This should always be done immediately after warm compresses. The aim is to apply pressure to the eyelids to clear the softened oil out of the glands, ready to be cleaned away.
Use your index finger to apply pressure to the eyelid whilst slowly rolling it towards the eyelashes
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Cleaning the lid margin and the eye lashes.
Use a cotton bud moistened with tap water or commercially available eyelid wipes to clean the edges of the eyelids gently but firmly, both where the eyelashes come out of the skin and behind the eyelashes. To clean behind the lashes, you will need to pull the eyelid away from the eye with your finger.
Eye Drops
Artificial tears like Hypromellose are helpful in providing comfort and Steroid Eye drops (Prednisolone Acetate 0.5% / Dexamethasone 0.1%) reduce the inflammation in the lids. In addition, Antibiotic eye ointments (Tetracycline) help to control the infection around the lashes and lids. Steroid eye drops should only be used under supervision by a doctor or qualified health care professional.
Oral Antibiotics
Doxycycline helps to liquefy the inspissated Meibomian Gland secretions. This, and other antibiotics can be used to treat infection around the lid margins.
The Dry Eye Syndrome
The Dry Eye Syndrome
What Is Dry Eye Syndrome?
What Is Dry Eye Syndrome?
Physiologically the surface of the eye is maintained constantly in a watery medium. When there is the inadequacy of tears it causes osmotic damage to the surface structures (cornea and conjunctiva) additionally causing symptoms.
What are the symptoms of dry eyes?
What are the symptoms of dry eyes?
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Gritty sensation of eyes-esp. under windy conditions.
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Changing/ blurred vision and fatigue
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Redness
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Need to blink excessively or squeeze the eyes
What causes Dry Eyes?
What causes Dry Eyes?
The watery medium around the eyes is maintained by the balance between the production of tear fluid and its loss. In fact, the tear film around the eye is constituted of 3 major layers contributed by different tissues of production.
Lipid layer- produced by meibomian glands at the lid margin. This layer is very important to cut down the evaporation of the aqueous layer
Aqueous layer- produced by lacrimal glands (major and minor), acts as a bath for the living cells on the surface of the eye.
Mucin layer- produced by conjunctival cells (Goblet Cells), helps to maintain fluid and other chemicals around the cells. The tear film is lost from evaporation, drainage through the nose into the throat and by spilling over the lower lids onto the cheeks. The disturbance of this balance between production and loss of tears, due to a myriad of factors, causes dry eye syndrome.
What are the risk factors for Dry Eye Syndrome?
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Age-many secreting tissues become dysfunctional with age.
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Reduced blinking and Eyelid Disease -These lower lipid secretion and impair the spread of fluid. Prolonged computer use and long-distance driving are incriminated.
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Contact lens wear- damages mucin-secreting cells over time.
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Eye and skin diseases-damage mucin secreting cells. Sjogren’s Disease and other Autoimmune Diseases, Vitamin A deficiency, and Rosacea.
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Chemical damage to eyes- these may vary from Acid or Alkaline burns of the eyes to long terms use of Eye Drops with preservatives.
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Neurological Dysfunction- Cataract Surgery, LASIK and other surgical procedures on the eyes as well as systemic neurological diseases like Parkinsonism can cause dry eyes
What are the Complications of Dry Eyes?
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Reduced Quality of Life- Affects driving, reading, and computer use
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Infections – Infections of the Cornea can set in in dry eyes
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Visual Dysfunction- Prolong dryness can cause surface tissue damage, scarring, and blurred vision.
Can it be treated?
1/ Treating Underlying Diseases
2/ Medications
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Artificial Tear Drops and Gels
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Immune Suppressive Medication (e.g. steroids)
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Serum
3/Surgical Procedures
