Blepharitis

Description

Blepharitis (blef-uh-RYE-tis) is inflammation of the eyelids. Blepharitis usually affects both eyes along the edges of the eyelids.

Blepharitis commonly occurs when tiny oil glands near the base of the eyelashes become clogged, causing irritation and redness. Several diseases and conditions can cause blepharitis.

Blepharitis is often a chronic condition that is difficult to treat. Blepharitis can be uncomfortable and unsightly. But do not usually cause permanent damage to the eye, and is not contagious.

Symptoms

Blepharitis signs and symptoms tend to be worse in the morning. They include:

  • Watery eyes
  • Red eyes
  • A gritty, burning or itching sensation in the eyes
  • Eyelids that appear greasy
  • Itching in the eyelids
  • Red, swelling of the eyelids
  • The peeling of the skin around the eyes
  • Scab tabs
  • The eyelids from sticking together
  • More frequent blinking
  • Sensitivity to light
  • Blurred vision, which usually improves with blinking

When to see a doctor

If you have blepharitis signs and symptoms that do not seem to improve despite good hygiene habits for regular cleaning and care of the affected area — make an appointment with your doctor.

Causes

The exact cause of blepharitis is not clear. Can be associated with one or more of the following:

  • Seborrheic dermatitis — dandruff of the scalp and the eyebrows
  • Infection
  • Clogged or malfunction of the sebaceous glands of the eyelids
  • Rosacea, a skin condition characterized by facial redness
  • Allergies, including allergic reactions to medicines for eyes, contact lens solution or eye makeup
  • Eyelash mites or lice
  • Dry eyes

Complications

If you have blepharitis, you may also have:

  • Lashes problems. Blepharitis can cause your eyelashes to fall out, grow abnormally (misdirected eyelashes) or lose the color.
  • The skin of the eyelid problems. The scarring may develop on the eyelids of long-term blepharitis. Or the edges of the lid can be rotated inward or outward.
  • Excess tearing or dry eyes.Abnormal oily secretions and other debris that is shed from the eyelids, such as flaking associated with dandruff, can build up in the tear film — the water, oil and mucus solution that is the form of tears. Abnormal tear film interferes with the maintenance of your eyelids wet. This can irritate the eyes and cause symptoms of dry eyes or excessive tearing.
  • Stye. A stye is an infection that develops near the base of the eyelashes. The result is a painful lump on the edge of their eyelids. A stye is the most visible on the surface of the eyelids.
  • The chalazion. A chalazion occurs when there is a blockage in one of the small oil glands at the margin of the eyelid, just behind the eyelashes. This obstruction causes the inflammation of the gland, which causes the eyelids to swell and redden. This can clarify or to become a hard, painless bump.
  • Chronic pink eye. Blepharitis can lead to recurrent bouts of pink eye (conjunctivitis).
  • Injury of the cornea. Constant irritation of the eyelids swollen or bad tabs can cause a sore develop on your cornea. Not having enough tears could increase your risk of an infection of the cornea.

Excess tearing or dry eyes. Abnormal oily secretions and other debris that is shed from the eyelids, such as flaking associated with dandruff, can build up in the tear film — the water, oil and mucus solution that is the form of tears.

Abnormal tear film interferes with the maintenance of your eyelids wet. This can irritate the eyes and cause symptoms of dry eyes or excessive tearing.

Blepharitis

Diagnosis

Tests and procedures used to diagnose blepharitis include:

  • The examination of the eyes. Your doctor may use a special magnifying instrument to examine your eyelids and your eyes.
  • Cleansing the skin to the test. In some cases, your doctor may use a swab to take a sample of oil or crust that forms on the eyelid. This sample may be analyzed for bacteria, fungi, or allergy testing.

Treatment

Self-care measures, such as the flushing of the eyes and the use of warm compresses, might be all that's needed for most cases of blepharitis. If self-care measures are not enough, your doctor might recommend prescription of treatments, including:

  • Medicines that fight infection.Antibiotics applied to the eyelid, has been shown to provide relief of symptoms and resolve the bacterial infection of the eyelids. These are available in several forms, including eye drops, creams, and ointments. If you do not respond to topical antibiotics, your doctor may suggest an oral antibiotic.
  • Medications to control the inflammation. Steroid eye drops or ointments are used for this, in general, only for those who do not respond to other therapies. Your doctor may prescribe antibiotics and anti-inflammatory.
  • Drugs that affect the immune system. Cyclosporine topical (Restasis) has been shown to offer relief from some of the signs and symptoms of blepharitis.
  • The treatments for underlying conditions. Blepharitis caused by seborrheic dermatitis, rosacea or other diseases that can be controlled by the treatment of the underlying disease.

Medicines that fight infection. Antibiotics applied to the eyelid, has been shown to provide relief of symptoms and resolve the bacterial infection of the eyelids. These are available in several forms, including eye drops, creams, and ointments.

If you do not respond to topical antibiotics, your doctor may suggest an oral antibiotic.

Other treatment options, such as the use of the intense pulsed light can unclog the glands. More studies are needed.

Blepharitis rarely disappears completely. Even with the success of the treatment, the condition often is chronic and requires daily attention with eyelid scrubs. If you do not respond to treatment, or if you have also lost the tabs or only one eye is affected, the condition may be caused by a localized cancer of the eyelid.

Self-care

Self-care measures may be the only treatment needed for most cases of blepharitis.

Clean your eyes daily

If you have blepharitis, follow this self-care for the correction of two to four times a day during flare-ups, and once or twice a day after that the disease is under control:

  • Apply a warm compress over your closed eye for a couple of minutes to loosen the crusty deposits on your eyelids.
  • Firmly, but gently massage the eyelids with a clean towel or a clean finger.
  • Immediately using a clean towel or cotton-tipped applicator moistened with warm water and a few drops of diluted baby shampoo or an over-the-counter eyelid cleanser to wash the oily residue or flakes on the base of your eyelashes. Use another clean cloth for each eye.
  • In some cases, you might need to be more careful about cleaning the edge of the eyelids, on your tabs. To do this, gently pull the eyelid away from your eye, and use the cloth to gently rub the base of the eyelashes. This helps to prevent damage to the cornea with the bath towel. Ask your doctor if you should use a topical antibiotic ointment after cleaning of the lids this way.
  • Rinse your eyelids with warm water and gently pat dry with a clean towel and dry.

In some cases, you might need to be more careful about cleaning the edge of the eyelids, on your tabs. To do this, gently pull the eyelid away from your eye, and use the cloth to gently rub the base of the eyelashes. This helps to prevent damage to the cornea with the bath towel.

Ask your doctor if you should use a topical antibiotic ointment after cleaning of the lids this way.

Could be of help to stop wearing eye makeup ... when your eyelids are inflamed. The make-up can make it more difficult to keep the eyelids clean and free of debris. Also, it is possible that the makeup could reintroduce bacteria in the area or cause an allergic reaction.

Lubricate the eyes

Try over-the-counter artificial tears. These eye drops can help relieve the dryness of the eyes.

The Control of the dander and dust mites

If you have dandruff that is contributing to your blepharitis, ask your doctor to recommend an anti-dandruff shampoo. The use of a dandruff shampoo may relieve your blepharitis signs and symptoms.

The use of tea tree oil shampoo on the eyelids day could help to deal with the mites. Or try scrubbing gently to the eyelids once a week with a 50% tea tree oil, which is available without a prescription. Contact your doctor if you don't see improvement in six weeks. And stop using tea tree oil if it irritates the skin or eyes.

Alternative medicine

There is No alternative medicine treatments have been shown to relieve the symptoms of blepharitis. However, a diet rich in omega-3 fatty acids or supplements that contain omega-3 fatty acids could help to blepharitis associated with rosacea. Omega-3 fatty acids are found in foods such as salmon, tuna, trout, flaxseed and walnuts. More studies are needed.

Preparing for your appointment

It is likely to start by seeing your family doctor. If your doctor suspects you may have an eyelid problem, such as blepharitis, you may be referred to an eye specialist (optometrist or ophthalmologist).

Here's some information to help you prepare for your appointment.

What you can do

Make a list of the following:

  • Your symptoms, including any that may seem unrelated to blepharitis, and when they began
  • All medications, vitamins or supplements that you are taking, including dose
  • Questions to ask your doctor

Blepharitis, questions to ask your doctor include:

  • What is likely causing my symptoms?
  • What are other possible causes of these symptoms?
  • What medical conditions that can cause this problem?
  • What tests are needed?
  • You should see a specialist?
  • Are there brochures or other printed material I can have? What sites do you recommend?
  • I continue to wear contact lenses?
  • Do I need to take special care to clean my contact lenses and my case?
  • I still wear eye makeup?
  • I'm going to need a follow-up visit? If so, when?

Do not hesitate to ask other questions.

What to expect from your doctor

Your doctor may ask you questions, such as:

  • Do your symptoms come and go, or do not always have?
  • Are your symptoms worse in the morning or late in the day?
  • Has been wearing contact lenses?
  • Have you changed brands of cosmetics recently?
  • Have you changed the soap or shampoo brands recently?
  • Nothing seems to improve the symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Has someone close to you has had a recent eye infection?
  • Have you ever had any eye diseases, eye surgery or injury to the eyes?
  • Do you have other illnesses or conditions?

What you can do in the meantime

While you wait for your appointment, you may find relief from the irritation of the eyes by gently wash your eyelids a couple of times each day. To wash your eyelids:

  • Apply a warm washcloth to your closed eyelids for five minutes.
  • Gently rub your eyelids closed with a dilute solution of baby shampoo. Use a clean towel or clean fingers. You might need to hold the lid away from the eye to rub it along the lash margin. The removal of the scales can require several minutes of gentle rubbing.
  • Rinse your eyes thoroughly with warm water.

Avoid anything that irritates the eyes, such as the eye make up and contact lenses.

Symptoms and treatment of Blepharitis