Blepharitis

Introduction

Your eyelids are an important anatomical structure of your eyes. They are functionally crucial but they are also susceptible to infection, trauma, and other eye-related complications such as blepharitis. There are tiny oil-producing glands that line the eyelid margins. Blepharitis is an acute inflammatory reaction of these glands. It is one of the most common inflammatory conditions of eyes that can contribute to dry eyes. 

What Causes Blepharitis?

There are various causes of blepharitis. Most of them are related to blockage of the oil-producing glands in the eyelids.

• Blocked meibomian or oil glands in the eyelids
• Bacterial and viral infections 
• Various skin conditions such as eczema, dermatitis, and rosacea
• Pollen and other allergens such as dust particles and smoke-related allergens
• Mites 

Signs and Symptoms of Blepharitis

Following are the signs and symptoms of blepharitis:

• Crusting and flaking around eyelashes
• Itchy eyes and eyelids
• Tender eyelids
• Dry eyes
• Eyelids may be glued together in the morning
• Swollen eyelids
• Foreign body sensation 
• Light sensitivity

How To Diagnose It?

There are various diagnostic tests to diagnose and classify the severity of blepharitis. 

• Slit lamp examination

• Your ophthalmologist will use a magnifying device to closely examine your eyelids for blepharitis

• Culture

• Your ophthalmologist may take a sample of discharge, crusting, or flaking from your eyes to evaluate for causative microorganisms 

What Are Treatment Options Available?

There is a wide range of options available to treat blepharitis. Usually, it is conservatively managed in the form of warm compresses, antibiotic drops and ointments, lid hygiene, and artificial tears.

• Prescription eye drops

Antibiotics or antibiotic-steroid combination drops and ointments are one potential treatment modality for blepharitis. They are usually used for a short period of time. Sometimes in case of severe blepharitis oral antibiotics may be prescribed for a prolonged duration. 

• Over-the-Counter Eye treatments 

In order to treat acute symptoms of blepharitis such as foreign body sensation and teary eyes, your ophthalmologist may advise you to use artificial tear drops, artificial tear gel, or to take certain vitamin supplements which can help control blepharitis.

• Warm compresses

Warm compresses on eyelids help in removing the clogged oily content in the glands. Warm compresses are often recommended two to three times daily for 20 minutes at a time. 

• Bleph-Ex

Bleph-Ex is an in-office treatment that provides long term relief from blepharitis. This procedure uses a gentle hand-held device to remove debris and bacteria from your eyelids in just 6-8 minutes. The effects of this procedure may last from 6 months to a year. Ask your eye care professional if Bleph-Ex is right for you. 

Prevention

It is recommended to clean the eyelids daily with a gentle soap, use warm compresses regularly, and always remove make-up before bed. Consider Bleph-Ex treatment for chronic blepharitis. 

Complications

Untreated blepharitis leads to the:

• Temporary or permanent scarring of eyelids.
• Dry eyes are the most common complication of blepharitis. In turn, it may lead to corneal infection.
• Styes/Chalazia.
• Loss of eyelashes.

References

1. NHS website. (2022b, February 10). Blepharitis. Nhs.Uk. Retrieved June 4, 2022, from https://www.nhs.uk/conditions/blepharitis/
2. What Is Blepharitis? (2022, March 15). American Academy of Ophthalmology. Retrieved June 4, 2022, from https://www.aao.org/eye-health/diseases/what-is-blepharitis
3. Blepharitis - Diagnosis and treatment - Mayo Clinic. (2022, May 10). Mayoclinic. Retrieved June 4, 2022, from https://www.mayoclinic.org/diseases-conditions/blepharitis/diagnosis-treatment/drc-20370148

Author

Eye Surgeons Associates Drs. Meiraj A. Siddiqui, Zuhair H. Peracha, Manal H. Peracha-Riyaz, Eric Zuckerman and Leila Siblani are dedicated to excellence in eye care and service. We utilize the latest treatment methods and procedures, including routine eye care, cataract surgery, glaucoma treatment, retinal disease management, diabetic eye treatment, and eyelid surgery.