Blepharitis is a chronic condition which affects the eyelids. It is a waxing and waning condition where there is an imbalance of the normal elements of the surface of the eye and eyelid margins. Often, due to external influences (such as the environment, etc.) and internal influences (such as hormonal factors), this imbalance can cause irritation, stinging, burning, redness or itchiness of the eyes. The severity can range from mild to severe.
Bacteria and oily particles can build up and coat the margin of the eyelids close to the lash margin and the eyelids can become irritated or swollen as a result. Some cases are associated with overgrowth of bacteria (the normal and beneficial bacteria that we all have on our skin and our eyelids) or dry eyes. It can also be associated with some types of skin conditions like acne rosacea.
Three Types of Blepharitis
Blepharitis can be either anterior or posterior. Anterior blepharitis is usually the result of a bacterial overgrowth and affects the portion of the eyelid where the eyelashes are attached. If it is not treated it can cause the eyelids (and thus the eyelashes) to turn outward or inward. Incorrect position of the eye lids (called entropion or ectropion) can damage the cornea and can cause serious vision problems.
Posterior blepharitis occurs when the tiny oil glands in the eyelid malfunction or become clogged. These glands, called meibomian glands, are located at the base of the eyelashes. When the meibomian glands get clogged a stye or a chalazion may form. Dysfunction of the oil glands can lead to crusty eyelids, dry eyes or cause the eyelids to thicken.
Some people have both types of blepharitis at the same time. Rosacea blepharitis is usually posterior, caused by oil glands that do not function properly because of an underlying inflammatory reaction. This condition can cause small bumps and redness of the face.
How is Blepharitis Diagnosed?
An eye doctor needs to examine an individual’s eyelids and ocular surface to determine whether or not they are suffering from blepharitis. In a typical eye exam, the ophthalmologist or optometrist will test the person’s vision, measure eye pressure, and perform a special exam called a slit-lamp microscope test. These can confirm that the individual has blepharitis.
What are the Treatment Options for Blepharitis?
For many people blepharitis is a chronic condition that never quite goes away. The symptoms may wax and wane, improving based on other health conditions or even in certain seasons. There are some treatments that might be suggested by an eye doctor to help control the symptoms.
- A warm compress may be used to help loosen debris or scales from around the eyelashes, as well as to help make the oily secretions less viscous. A wet, warm cloth may also help decrease the backed-up oil in the oil glands which can help prevent chalazion.
- Gently scrubbing the eyelids with a soft moist cloth may also be beneficial. Especially after a warm compress has been applied.
- In some cases the ophthalmologist might prescribe an antibiotic ointment or drops. This treatment can reduce inflammation in the area by temporarily decreasing the bacterial load. It is important to remember that antibiotics are not a cure for this condition—they are only a treatment adjuvant usually reserved for a more severe flare.
- Steroid eyedrops or artificial tears may also be prescribed. These can help temporarily reduce inflammation and relieve dry eyes.
- Nutritional therapy may be useful for some sufferers. When the body is missing certain nutrients, it may cause blepharitis of the meibomian gland. When the omega fatty acids are unbalanced, the oil glands which normally lubricate the eyes can become abnormal. An ophthalmologist may suggest a diet plan as well as nutritional supplements which can help correct the imbalance.
- Oral antibiotics are occasionally used to help the oil glands empty more readily.
- Blepharitis for many is an ongoing condition but may be slowed or its effects reduced by cleaning the skin and eyelids regularly. An antibacterial shampoo may be used on the hair, eyebrows and scalp to help reduce or control blepharitis.