Blepharitis

Blepharitis means inflammation of the eyelids.  Some doctors call it granulated eyelids. Almost everyone gets blepharitis at some time in his or her life. Some people get it repeatedly. Fortunately, blepharitis is relatively easy to treat.

Types of blepharitis:

Staphylococcus blepharitis is caused by a germ called Staphylococci, commonly known as “staph.” It often begins in childhood and continues throughout adulthood. This form of the condition results in collar scales on lashes, crusting, and chronic redness at the lid margin. Dilated blood vessels, loss of lashes, sties, and chalazia (nodules on the eyelids) also occur.

Seborrhea blepharitis is the most common and least severe form of this condition. 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. Hormones, nutrition, general physical condition and stress are factors in seborrhea.

Ulcerative blepharitis is a less common but more severe condition that may be characterized by matted, hard crusts around the eyelashes, which, when removed, leave small sores that may bleed or ooze. There may also be a loss of eyelashes, distortion of the front edges of the eyelids and chronic tearing.

In severe cases, the cornea, the transparent covering of the front of the eyeball, may also become inflamed.

Symptoms of blepharitis:

• Itchy, burning, watery eyes
• Sore eyes
• Sticky discharge that causes the eyelashes to stick together
• Redness of the eyelid edges
• 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. You can do this by moistening a clean washcloth with tap water as warm as you can stand without burning. Hold the washcloth against the eyelids until it cools, then rewarm and repeat for five to ten minutes.

After soaking, scrub each eyelid gently for one minute using a clean washcloth wrapped around your index finger and moistened with warm tap water. Cotton-tipped applicators, like Q-tips, are also useful to remove accumulated material from the eyelashes.

To remove excessive amounts of material from your eyelids, use a few drops of a non-irritating shampoo, such as baby shampoo, mixed in lukewarm water. Being careful to avoid getting shampoo in your eye, scrub back and forth along the eyelashes of all eyelids, and then rinse with plain tap water. Once the redness and soreness are under control, this cleaning may be decreased from daily to twice weekly. 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 will 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, medications taken by mouth are helpful. Most of these medications are antibiotics that also improve or alter the oil composition of the eyelid oil glands. When taken properly, they are safe. However, side effects may occur in some individuals, including skin rash, slight nausea and increased sensitivity to sun.

Although medications may help control the symptoms of blepharitis, they alone are not sufficient; keeping the eyelids clean is essential.

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