What is blepharitis?

Blepharitis is a common condition that causes inflammation of the eyelids. The condition can be difficult to manage because it tends to recur.

What other conditions are associated with blepharitis?

Complications from blepharitis include:

Stye :

A red tender bump on the eyelid that is caused by an acute infection of the oil glands of the eyelid.

Chalazion :

This condition can follow the development of a stye. It is a usually painless firm lump caused by inflammation of the oil glands of the eyelid. Chalazion can be painful and red if there is also an infection.

Dry eye/problems with the tear film :

Abnormal or decreased oil secretions that are part of the tear film can result in excess tearing or dry eye. Because tears are necessary to keep the cornea healthy, tear film problems can make people more at risk for corneal infections.

Corneal ulcers/scarring :

Recurrent inflammation can cause acute ulcers and abscess along with thinning scarring and new blood vessel formation.

Pain and foreign body sensations :

Inflammation from blepharitis can cause ongoing pain and soreness by irritating very sensitive corneal nerves. This can be exacerbated by anxiety and stress and depression and when the eyes become a psychological focus of attention.

What causes blepharitis?

Blepharitis occurs in two forms:

Anterior blepharitis affects the outside front of the eyelid, where the eyelashes are attached. This can cause scaling of the skin and is sometimes associated with bacterial or Demodex mite infection.

Posterior blepharitis affects the inner eyelid (the moist part that makes contact with the eye) and is caused by problems with the oil (meibomian) glands in this part of the eyelid. Skin disorders can cause this form of blepharitis: acne rosacea, which leads to red and inflamed skin, and (seborrheic dermatitis).

What are the symptoms of blepharitis?

Symptoms of either form of blepharitis include a foreign body or burning sensation, excessive tearing, itching, sensitivity to light (photophobia), red and swollen eyelids, redness of the eye, blurred vision, frothy tears, dry eye, or crusting of the eyelashes on awakening.

How is blepharitis treated?

Treatment for both forms of blepharitis involves keeping the lids clean and free of oil and crusts. Warm compresses or microwav eye bags should be applied to the lid to loosen the secretions followed by a light scrubbing of the eyelid with a cotton swab and a mixture of water and baby shampoo or bicarbonate of soda. Commercial lid care wipe can also be used. Newer ones with tea tree oil can be beneficial.

Because blepharitis rarely goes away completely, most patients must maintain an eyelid hygiene routine for life. If the blepharitis is severe, an eye care professional may also prescribe antibiotics or steroid eyedrops or tetracycline tablets.

Flaxseed oil supplements /Omega oil or powder in the diet are also of benefit.

Investigations :

Sometimes investigations of tear film quality or inflammation are useful and occasionally referral to dermatology services is made. Imaging of the glands of the eyelids can be made using techniques like Lip view.

Lid treatments :

More intensive regular treatment in clinic with Blephex or Lipiflow are often helpful in more severe or persistent cases. Antibiotic drops or tetracycline tablets may be used especially when there is Rosacea or corneal involvement.

Diet :

Turmeric, ginger, cruciferous vegetables and coconut all help as stabilising the body bacterial flora.