Blepharitis

What is Blepharitis?


Inflammation of the lid margin is the most common disease of the eye.  It is often associated with dry eyes and can produce similar symptoms with soreness and a gritty sensation and in severe cases the lid margins themselves look red and can be associated with some redness of the eye.

Blepharitis - note crusting at base of lashes of upper lid

Blepharitis - note crusting at base of lashes of upper lid

There are two types of inflammation that affects the lid, an inflammation at the base of the lashes that produces crusting of the lid and lashes (like dandruff of the lashes) and an inflammation of the glands that produce an oil that contributes to the tears (it floats on the watery layer in the tears to stop the water from evaporating too quickly). Inflammation of the oil glands in the lid is sometimes termed meibomianitis or posterior blepharitis as the gland that produce the oil are called meibomian glands and the pores are situated all along the upper and lower lid just behind the base of the lashes. Most patients with blepharitis will have a combination of both crusting of the lashes and inflammation of the oil glands.

What is the treatment for blepharitis?

 

The main treatment for blepharitis remains regular bathing of the lid margins or “lid hygiene”. This should be performed at least once a day (preferably first thing in the morning). This should be performed as follows: Place a clean flannel under the warm tap, roll it up and place the flannel against the closed eyelids for a minute or two. This in itself is a comforting experience but the warm flannel will be heating up the oily secretions and any pores blocked by thick oils may become unblocked as the heat thins the oil.

 

After using the flannel any crusts on the base of the lashes or oils can be removed by gently but firmly wiping the lid margins (where the lashes come out) with either a gauze swab or cotton bud or ball that has been dipped in cooled boiled water to which a few drops of baby shampoo (which can be safely used around the eyes) has been added. There are also however “lid hygiene / lid care” kits available from the chemist that already provide clean gauze swabs and a bottle of sterile weak soapy solution and if you do not find you have much time in the morning these are the simpler solution.  There are also eye pads that you heat up in the microwave that can be used in place of a hot flannel.

Do not forget however that blepharitis is often associated with dry eyes and artificial tears may also help.

More severe forms of blepharitis can benifit from a short course of antibiotic tablets such as Azithromycin at a dosage of 500mg for one day then 250mg for 5 days and a short course of combined antibiotic and steroid ointment called Maxitrol that is applied to the lid margins twice a day for 2 weeks.  This type of treatment for severe blepharitis needs supervision by an eye doctor.