Blepharitis

What is blepharitis?

BlepharitisBlepharitis is an inflammatory disease of the eyelids characterized by dandruff-like scales on the eyelashes which can result in red, itchy, dry, crusted, and irritated eyelids. In its earliest stages, blepharitis may not have any significant symptoms. When the blepharitis reaches a moderate to severe amount of inflammation, extreme discomfort may be occur. If the blepharitis is also contribution to ocular surface disease, vision may be affected significantly.

Who can be affected by blepharitis?

This common condition affects patients of all ages. While certainly uncomfortable, blepharitis in and of itself is not contagious and generally does not result in permanent eye damage.

What are the two types of blepharitis?

There are generally two types of blepharitis, anterior blepharitis and posterior blepharitis. Anterior blepharitis occurs along the external portion of the lids around the base of the eye lashes. Posterior blepharitis (also called ‘meibomitis) affects the inner edge of the eyelid that comes in contact with the eyeball, specifically at the oil glands (called ‘meibomian glands’). These two types can occur simultaneously or separately. We refer to Anterior blepharitis simply as “Blepharitis” and posterior blepharitis simply as “Meibomitis”).

What causes blepharitis?

Blepharitis is typically the result of a Staphlococcus infection, an anterior blepharitis can also result from dandruff of the scalp or eyebrows. It may also occur due to a combination of factors, or less commonly may be the result of allergies or an pest infestation of the eyelashes.

How is blepharitis diagnosed?

Blepharitis is typically diagnosed at a patient’s annual comprehensive eye and vision 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 under the bio-microscope.
  • Evaluation of the quantity and quality of tears – for any abnormalities.

How is blepharitis treated?

Treatment depends on which type of blepharitis the patient has. The key to treating most types of blepharitis is keeping the lids clean and free of crusting.

  • 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 a doctor-recommended lid cleansing product.
  • An antibiotic may be prescribed for infectious cases.
  • If the oil glands in the eyelids are blocked, your optometrist may need to express the glands with a medical instrument under the microscope in the exam room.
  • Artificial tear solutions or lubricating ointments may be prescribed.
  • Limiting or stopping the use of eye makeup may be recommended, as its use will make lid hygiene more difficult.
  • You may have to temporarily discontinue wearing contact lenses during treatment.

Directions for an eyelid scrubs:

  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. Using a clean cloth (a different one for each eye), rub the solution back and forth across the eyelashes and edge of the closed eyelid.
  4. Rinse with clear water.
  5. Repeat with the other eye.

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