Blepharitis

Blepharitis is an infection of the eyelids.  Some patients call it granulated eyelids. Almost everyone has some form of blepharitis.  It is caused by a bacteria that is part of our normal makeup but then gets out of hand and concentrates on the eyelids and eye, a nice warm environment that helps the bacteria grow.  Blepharitis causes alot of problems for some people but not for others. Fortunately, blepharitis is relatively easy to treat. However, it is a chronic condition and needs to be taken care of on an ongoing basis, like brushing or flossing your teeth.

Types of blepharitis:

Staphylococcus blepharitis is caused by a bacteria called Staphylococci, commonly known as "staph." It often begins in childhood and continues throughout adulthood. This form of the condition results in dandruff like debris and scales on the lashes along with crusting and chronic redness at the lid margin. If left untreated, loss of eyelashes can result along with red inflamed eyelids.  Eventually a blockage of the oil glands along the eyelid margins can lead to styes, also known as chalazia.  In severe cases, the cornea, the transparent covering of the front of the eyeball, may also become inflamed and vision affected.

Seborrheic blepharitis is a common form of this condition as well. It is not an infection but is caused by improper function of the oil glands, which causes greasy, waxy scales to accumulate along the eyelid margins. Seborrhea may be a part of an overall skin disorder that affects other areas. Dandruff of the scalp, hormones, nutrition, general physical condition and stress are factors in seborrhea.

Symptoms of blepharitis:

• Itchy, burning, watery eyes
• Matter in the corners of the eyes on awakening
• Redness of the eyelids
• Frequent sty formation
• Tiny pimples on the eyelid edges
• Scaly skin flakes along the eyelid margins
• Gritty sensation leading to irritated eyes and light sensitivity
• Blurred vision

Causes of blepharitis:

• Poor eyelid hygiene
• Excess oil produced by the glands in the eyelid
• Bacterial infection (often staphylococcal)
• Allergic reaction

Treating blepharitis:

In addition to eliminating redness and soreness, treatment can prevent potential infection and scarring of the cornea. You doctor will perform a complete eye examination to determine the most effective treatment.

Cleaning
Usually, blepharitis can be controlled by careful, daily cleaning of the eyelashes.  The best way is to use pre-medicated lid scrub pads (Ocusoft), available over the counter in the eyecare/contact lens product section of any pharmacy or grocery store.  With this pad, clean along the lash margin (both upper and lower lids) with the eye closed for 20 or 30 seconds. Rinse with warm tap water.  Turn the pad over and clean the other eye. REPEAT nightly for two weeks, then every other night as part of your daily hygiene routine.  Your doctor may modify these instructions depending on your particular eye condition.

If you have small or large pimples or bumps forming on the lids, you can moisten a clean washcloth with tap water as warm as you can stand it without burning. Hold the washcloth against the eyelids until it cools, then rewarm and repeat throughout the day.

An alternative to the lid scrub pads is to mix a few drops of baby shampoo in lukewarm water. Being careful to avoid getting shampoo in your eye, scrub back and forth along the eyelashes of all eyelids, either with a washcloth draped over your finger or a cotton swab (Q-tip).  Rinse with plain tap water.

Once the redness and soreness are under control, this cleaning may be decreased from daily(usually at bedtime) to every other night. However, if the symptoms return, return to daily cleansing immediately.

Medication
In some cases, your doctor may prescribe eye drops or ointment to be used along with the daily cleansing regimen. For ointments, use a clean fingertip to rub a small amount into the eyelashes. Be careful to follow recommended dosages; excess medication may cause temporary blurring of vision. And with any medication, there is a small possibility of allergy or other reaction. If you think this is happening, stop the medication and contact your doctor immediately.

For certain types of blepharitis, antibiotics taken by mouth are helpful. These will often improve the oil composition of the eyelid glands, leading to a healthier ocular surface. When taken properly, they are safe. Ask your Doctor of Optometry if these medications are appropriate for you.  If so, your doctor will take a thorough drug allergy history and write you a prescription for the appropriate oral medication.

Remember that although topical and oral medications may help control the symptoms of blepharitis, they alone are not sufficient; keeping the eyelids clean on an ongoing basis is essential ! 

If you think you may have blepharitis, your eye doctor can determine the cause and recommend the right therapy specifically designed for you.