BLEPHARITIS

What is Blepharitis?

Blepharitis is a chronic inflammation of the eyelids which causes irritation, itching, and occasionally a red eye. The eyelids are composed of skin on the outside and mucous membranes on the inside. A cartilage-like plate, muscles, and glands are sandwiched in between. Blepharitis can begin in early childhood producing “granulated eyelids,” and may continue throughout life as a chronic condition or it may develop in later life. It may appear in one of two ways:

Seborrheic blepharitis is characterized by redness of the lids, scales and flaking around the eyelashes. It is often associated with dandruff of the scalp.

Ulcerative blepharitis is usually a more severe condition caused by bacteria and is characterized by matted hard crusts around the eyelashes which upon removal leave small ulcers that may bleed or ooze. The white part of the eye may turn red. In severe cases the cornea (the clear part of the eye) may become inflamed.

Signs and Symptoms

There is usually a build-up of a lot of mucous and crusts on the eyelashes, irritation of the surface of the eyeball, itching, sensitivity to light, or other similar symptoms. There may be a loss of eyelashes and distortion of the margins of the eyelids which can cause chronic tearing.

How is Blepharitis treated?

The treatment usually consists of three parts.

First, is the use of warm (not hot) compresses to the eyelid area. A clean washcloth or small towel soaked in warm tap water and held on the closed eyelids for three to five minutes, two or three times per day is best.

Secondly, in view of the long-term nature of the condition, strict lid hygiene is necessary. The following regimen may be useful:

1.    Fill a glass with warm water.
2.    Add 3 drops of baby shampoo (No More Tears)
3.    Take a clean cotton ball and soak it in the solution.
4.    Gently scrub both eyelids for two minutes with the eyes closed.
5.    Rinse with cool tap water
6.    Gently dry with a soft towel
7.    Use medications as directed.

Treatment of an oily scalp with antidandruff shampoo my also be helpful.

The third part may involve the use of various antibiotics and even cortisone preparations to alleviate the condition. Medicine is rarely of value without the other measures.

Once the acute phase is controlled, lid hygiene as described above and the use of bland ointments may be sufficient to maintain control of blepharitis.

While cortisone preparations often hasten relief of symptoms long-term use can cause side effects. Some susceptible individuals may develop glaucoma, cataracts, or virus infections from prolonged steroid use.