Blepharitis is an inflammation
of the eyelids and eyelashes causing red, irritated, itchy
eyelids and the formation of dandruff-like scales on eyelashes.
It is a common eye disorder generally caused by either
a bacterial infection or a general skin condition such
as dandruff of the scalp or acne rosacea. It affects people
of all ages. Although uncomfortable, blepharitis is not
contagious and does not cause any permanent damage to
eyesight.
Blepharitis is classified
into two types:
1.Anterior blepharitis occurs
at the outside front edge of the eyelid where the eyelashes
are attached.
2.Posterior blepharitis affects the inner surface of the
eyelid that comes in contact with the eyeball.
Individuals with blepharitis
may experience a gritty or burning sensation in their
eyes, excessive tearing, itching, red and swollen eyelids,
dry eyes, or crusting of the eyelids. For some people,
blepharitis causes only minor irritation and itching.
However, it can lead to more severe symptoms such as blurring
of vision, missing or misdirected eyelashes, and inflammation
of other eye tissue, particularly the cornea.
In many cases, good eyelid
hygiene and a regular cleaning routine can control blepharitis.
This includes frequent scalp and face washing, using warm
compresses to soak the eyelids, and doing eyelid scrubs.
In cases where a bacterial infection is the cause, various
antibiotics and other medications may be prescribed along
with eyelid hygiene.
What
causes blepharitis?
Blepharitis can appear as
greasy flakes or scales around the base of the eyelashes.
Anterior blepharitis is commonly
caused by bacteria (staphyloccus blepharits) or dandruff
of the scalp and eyebrows (seborrheic blepharitis). It
may also occur due to a combination of factors, or less
commonly may be the result of allergies or an infestation
of lice on the eyelashes.
Posterior blepharitis can
be caused by excessive oil production by the glands of
the eyelids (meibomian blepharitis) which creates a favorable
environment for bacterial growth. It can also develop
as a result of other skin conditions such as acne rosacea
and scalp dandruff.
How is
blepharitis diagnosed?
Blepharitis can be diagnosed
through a comprehensive eye examination. Testing, with
special emphasis on evaluation of the eyelids and front
surface of the eyeball, may include:
* Patient history to determine
any symptoms the patient is experiencing and the presence
of any general health problems that may be contributing
to the eye problem.
* External examination of the eye, including lid structure,
skin texture and eyelash appearance.
* Evaluation of the lid margins, base of the eyelashes
and meibomian gland openings using high intensity light
and magnification.
* Evaluation of the quantity and quality of tears for
any abnormalities.
A differentiation among the
various types of blepharitis can often be made based on
the appearance of the eyelid margins:
* Staphyloccal blepharitis
patients frequently exhibit mild sticking together of
the lids, thickened lid margins, and missing and misdirected
eyelashes.
* Seborrheic blepharitis appears as greasy flakes or scales
around the base of eye lashes and a mild redness of the
eyelids.
* Ulcerative blepharitis is characterized by matted, hard
crusts around the eyelashes which when removed leave small
sores that ooze and bleed. There may also be a loss of
eyelashes, distortion of the front edges of the eyelids
and chronic tearing. In severe cases, the cornea, the
transparent front covering of the eyeball may also become
inflamed.
* Meibomian blepharitis is evident by blockage of the
oil glands in the eyelids, poor quality of tears, and
redness of the lining of the eyelids.
Using the
information obtained from testing, your optometrist can
determine if you have blepharitis and advise you on treatment
options.
How is
blepharitis treated?
Treatment depends on the
specific type of blepharitis. The key to treating most
types of blepharitis is keeping the lids clean and free
of crusts.
•Warm compresses can be applied to loosen the crusts,
followed by gentle scrubbing of the eyes with a mixture
of water and baby shampoo or an over-the-counter lid cleansing
product. In cases due to bacterial infection, an antibiotic
may be prescribed, along with lid hygiene.
•If the glands in the eyelids
are blocked, the eyelids may need to be massaged to clean
out oil accumulated in the eyelid glands.
•If the blepharitis makes
the eyes dry, artificial tear solutions or lubricating
ointments may be prescribed.
•If lice are the cause, petroleum
jelly can be applied along the base of the eyelashes to
eliminate them.
Use of an anti-dandruff shampoo
on the scalp can help. In addition, limiting or stopping
the use of eye makeup is often recommended, as its use
will make lid hygiene more difficult. If you wear contact
lenses, you may have to temporarily discontinue wearing
them during treatment.
Blepharitis seldom disappears
completely. Even with successful treatment, relapses may
occur.
Self-care
An important part of controlling
blepharitis involves treatment at home. Warm compresses
can be used to loosen crusts on eyelashes, followed by
gently scrubbing the eyelashes.
Directions for a Warm Soak
of the Eyelids:
1.Wash your hands thoroughly.
2.Moisten a clean washcloth with warm water.
3.Close eyes and place washcloth on eyelids for about
5 minutes.
4.Repeat several times daily.
Directions for an Eyelid
Scrub:
1.Wash your hands thoroughly.
2.Mix warm water and a small amount of non-irritating
(baby) shampoo or use a commercially prepared lid scrub
solution recommended by your optometrist.
3.Close one eye and using a clean cloth (a different one
for each eye) rub the solution back and forth across the
eyelashes and edge of the eyelid.
4.Rinse with clear, cool water.
5.Repeat with the other eye.
