Blepharitis

Blepharitis is a common inflammation of eyelash follicles and meibomian glands of the upper or lower eyelids. It gives a red-rimmed appearance to the eyelid margins. The disorder, which may affect both eyes (and both upper and lower eyelids), tends to recur and may become chronic.

Blepharitis does not usually affect vision or damage the eye. It is a chronic, manageable condition in most cases. If left untreated, it can lead to a more serious condition called ulcerative blepharitis . This is usually caused by a bacterial infection and can cause loss of eyelashes, eyelid scarring, and inflammation of the cornea.

Seborrheic (nonulcerative) blepharitis is more common in elderly people but also may affect people with red hair. Staphylococcal (ulcerative) blepharitis may coexist with seborrheic blepharitis. Both types can be controlled if treatment begins before the onset of ocular involvement.

Causes

Seborrheic blepharitis generally results from seborrhea of the scalp, eyebrows, and ears; ulcerative blepharitis, from a Staphylococcus aureus infection. (Chalazia and styes are likely to develop with this infection.)

Blepharitis Symptoms and Signs

Regardless of which type of blepharitis you have, you will probably have such symptoms as eye irritation, burning, tearing, foreign body sensation , crusty debris (in the lashes, in the corner of the eyes or on the lids), dryness, and red eyelid margins.

It is important to see an eye doctor and get treatment. If your blepharitis is bacterial, possible long-term effects are thickened lid margins, dilated and visible capillaries, trichiasis , eyelash loss, ectropion and entropion . The lower third of the cornea may exhibit significant erosion .

Diagnostic tests

Your doctor will be able to diagnose blepharitis after carefully examining your eyes and eyelids. He or she may use a special magnifying instrument during the examination. Sometimes, a sample of the skin deposits may be collected to see if any bacteria are present.

Treatment

Early treatment is essential to prevent recurrence or complications. For patients with seborrheic blepharitis, treatment includes daily shampooing (using a mild shampoo on a cotton-tipped applicator or a washcloth) to remove scales from the eyelid margins. Patients should also shampoo the scalp and eyebrows and follow up with warm eye compresses.

A patient with ulcerative blepharitis requires the same treatment, in addition to a sulfonamide or an appropriate antibiotic eye ointment at bedtime.

A combination antibiotic and steroid, such as prednisone (sulfa and steroid; Vasocidin or Blephamide), may be used.

Treatment for a patient with blepharitis resulting from pediculosis involves removing the nits with forceps or applying ophthalmic physostigmine or other insecticidal ointment.

Lid Massage :- Using a finger / cotton bud firmly stroke the skin of the lids towards the lashes, i.e. downwards for the top lid and upward for the bottom lid. Massage the whole width of the eyelids. This helps unblock the meibomian glands and expresses the oils.

Prevention

Keeping the eyelids, scalp, and face clean is the most effective way to prevent blepharitis and its recurrence. Avoiding exposure to smoke and chemical fumes and obtaining treatment for skin disorders like rosacea and seborrhea also helps prevent blepharitis

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