What to know about Blepharitis

What is Blepharitis?

Blepharitis is a common and persistent inflammation of the eyelids. Symptoms include irritation, itching, and occasionally, a red eye.

This condition frequently occurs in people who have oily skin, dandruff, or dry eyes. Blepharitis can begin in early childhood, producing “granulated eyelids,” and continue throughout life as a chronic condition, or develop later in life.

Bacteria reside on the surface of everyone’s skin, but in certain individuals they thrive in the skin at the base of the eyelashes. The resulting irritation, sometimes associated with over-activity of the nearby oil glands, causes dandruff-like scales and particles to form along the lashes and eyelid margin. In Blepharitis, both upper and lower eyelids become coated with oily debris and bacteria near the base of the eyelashes. The eye feels irritated and may become inflamed. Regular, thorough cleansing of the lid margin helps control Blepharitis.

Blepharitis occurs in two forms:

• Anterior Blepharitis – affects the outside front of the eyelid where the lashes are attached. The two most common causes of anterior Blepharitis are bacteria (staphylococcus) and scalp dandruff.
• Posterior Blepharitis – affects the inner eyelid (the moist part that makes contact with the eye) and is caused by problems with the oil glands (meibomian glands) in this part of the eyelid. Two skin disorders can cause this form of Blepharitis: acne rosacea, which leads to red and inflamed skin, and scalp dandruff (seborrheic dermatitis).

For some people the scales or bacteria associated with Blepharitis produce only minor irritation and itching, but in others they may cause redness, stinging or burning. Some people may develop an allergy to the scales or to the bacteria which surround them. This can lead to a more serious complication — inflammation of the eye tissues, particularly the cornea (the clear “front window” of the eye).

Will medication help?

Dr. Fava notes that many medications are available for the treatment of Blepharitis, and antibiotics, including antibiotics and steroid (cortisone) combinations in drop or ointment form. While cortisone medications often hasten relief of symptoms, long-term use can cause some harmful side effects such as glaucoma and progression of cataracts.

Once the acute phase of the condition is overcome – a process which may take several weeks, milder medications, if any, may be helpful to control your Blepharitis. However, medications alone are not sufficient; the daily cleansing routine described above is essential.

What about supplements?

Recently, some authorities have suggested using flax oil supplements (omega-3 fatty acid), either by pill or by liquid, to stabilize the meibomian secretions associated with meibomian seborrheic Blepharitis. Be sure to discuss any supplement use with your doctor.

Can I continue to wear my contact lenses?

Because Blepharitis tends to be chronic, expect to keep up the therapy for a prolonged period of time to keep it a bay. Depending on the type of Blepharitis you have, if you wear contact lenses, your doctor may want you to discontinue wearing them during the treatment period and even beyond. Some patients who wear soft contact lenses are prescribed RGP contacts instead. Others are urged to replace their soft lenses more frequently because of the potential for excessive deposit buildup. Some people simply don’t do well with contact lenses and will have to consider other options.

Can I still wear makeup?

Not wearing eye makeup, while the disease is more active, is also a good idea, since it can get in the way of eyelid hygiene and massage treatments. With some kinds of Blepharitis, it is recommended that you use an anti-dandruff shampoo for your scalp and eyebrows.

Why are regular medical eye examinations important for everyone?

Eye disease can occur at any age. Many eye diseases do not cause symptoms until damage has occurred. Since most blindness is preventable if diagnosed and treated early, regular medical examinations by an ophthalmologist are very important. Why an ophthalmologist? In short, an ophthalmologist (MD or osteopath) provides total eye care: medical, surgical and optical.

Our office provides comprehensive medical and surgical services as well as vision care, glasses, and contact lenses. Please feel free to recommend us to your friends and family.