Blepharitis is an inflammation of the eyelid often caused by bacteria. Other causes include disorders of the oily glands in the eyelids (meibomian glands) and parasitic eyelash mites (known as Demodex Folliculorum).
Blepharitis often develops as a result of the interaction between the different causal factors. The bacteria that live along the eyelid margins can overgrow and create a favourable environment for eyelash mites to thrive on. This can attract and increase the number of parasitic eyelash mites which in turn irritate the eyelids and cause them to get inflamed. The bacteria on the eyelid margins can also produce toxins that cause an inflammation of the meibomian glands. When the meibomian glands are inflamed, they become clogged, production of tears is affected and this causes or worsens dry eye syndrome.
Blepharitis may also be an eyelid manifestation of skin diseases like rosacea, psoriasis and seborrheic dermatitis.
Symptoms
- Burning sensation
- Crusty debris or dandruff-like flakes at the base of the eyelashes
- Irritated and watery eye
- Itchy eyelid margins
- Foreign body/ gritty sensation
- Swollen and red eyelid margin
- Loss of eyelashes (madarosis) in severe cases
Diagnosis
To diagnose blepharitis, your eye doctor will take a detailed case history and conduct a physical examination of your eyes using an instrument that magnifies the image of your eyes. This could be a slit lamp or a magnifying lens. Your doctor may also collect a sample of the debris on your eyelid for laboratory testing to determine the exact causative factor. Laboratory testing is important particularly when symptoms are severe or the condition reoccurs frequently.
Treatment
Eyelid hygiene
Maintaining good eyelid hygiene is essential for the management of blepharitis. The eyelid margins should be scrubbed with a clean towel dipped in diluted baby shampoo to remove bacteria, eyelash mites and crusts that have built-up on them. Alternatively, eyelid cleansers and pre-moistened wipes found in pharmacies can be used.
Warm compress
Warm compresses help to open up blocked meibomian gland ducts and allow the content to flow out.
If warm compress does not unclog the meibomian gland ducts, your doctor would use one or more clinical procedures such as electromechanical lid margin debridement (Bleph Ex), thermal pulsation treatment (lipiflow) and intense pulsed light therapy to unclog the ducts.
Medications
Blepharitis can also be treated using medications such as antibacterial eye drops and ointments, anti-inflammatory drops and ointments and anti-histamines (to relieve itching). Omega 3-fatty acids supplements may also be prescribed to help keep the meibomian glands healthy.
Prevention
Blepharitis can be prevented by taking precautions to avoid the overgrowth of bacteria, eyelash mites and clogging of the meibomian gland ducts.
Maintaining good eyelid hygiene at all times is essential. To do this,
- Washing your face regularly.
- Remove all make-up before going to bed. Wearing make-up particularly eyeliner can clog the meibomian gland ducts and encourage the growth of bacteria on your eyelid if worn overnight
- Avoid rubbing your eyes to prevent infection. If you must touch your eyes, wash your hands properly before you do so.
- Get proper treatment for dandruff and any other skin conditions that can cause blepharitis.
- Use eyelid scrubs daily if you have had recurrent blepharitis.