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?

Usually, it’s a combination of factors that brings in the condition and the combinations vary from patient to patient

1/ Bacterial and Demodex related Anterior Blepharitis- Lid margin infection by resident bacteria results in the formation of crusts on lashes.

2/Seborrheic Anterior Blepharitis- Excessive meibomian secretions commonly associated with seborrheic dermatitis of the scalp resulting in flakes at the margin and on the lashes.

3/ 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?

In addition to Blepharitis being an irritating condition both cosmetically and functionally, it also can produce complications like:

1/ Dry Eyes

2/ Chalazion / Hordeolum (Lid margin abscesses)

3/ Cellulitis of Lids

4/Corneal Ulceration

5/ Corneal Vascularization

How is Blepharitis treated?

1/ Lid Hygiene- this is the cornerstone of controlling blepharitis and includes

· 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

· 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

· 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.

2/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.

3/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.