Blepharitis is a common eye condition characterized by chronic inflammation of the eyelid, usually where eyelashes grow, resulting in inflamed, irritated, itchy, and reddened eyelids. A number of diseases and conditions can lead to blepharitis. It can be caused by the oil glands at the base of the eyelashes becoming clogged, a bacterial infection, allergies, or other conditions.
The severity and course can vary. Onset can be acute, resolving without treatment within 2–4 weeks (this can be greatly reduced with lid hygiene), but more generally is a long-standing chronic inflammation of varying severity.
It may be classified as seborrhea, staphylococcal, mixed, posterior or meibomitis, or parasitic. It usually does not cause permanent damage.
SYMPTOMS: – Symptoms associated with blepharitis include:
• Watery eye
• Red eyes
• Red/swollen eyelids
• Crusting at the eyelid margins/base of the eyelashes/medial cantus, generally worse on waking
• Eyelid sticking
• Eyelid itching
• Flaking of skin on eyelids
• Gritty/burning sensation in the eye, or foreign-body sensation
• Eyelids appear greasy
• Frequent blinking
• Light sensitivity/photophobia
• Misdirected eyelashes that grow abnormally
• Eyelash loss
• Infection of the eyelash follicle/sebaceous gland (hordeolum)
• Debris in the tear film, seen under magnification (improved contrast with use of fluorescein drops)
DIAGNOSIS: – The doctor typically diagnoses the condition on physical examination of the area. A specimen of material is occasionally collected for bacterial or fungal testing
PREVENTION:- Careful daily washing of the eyelids seems to prevent blepharitis. A simple routine is to wash each eyelid for 30 seconds twice a day, using a clean face flannel with a single drop of nonirritant soap (e.g. baby shampoo) and ample water.
TREATMENT: – Blepharitis does not often disappear entirely, and even successful treatment is often followed by relapses.
A Cochrane Systematic Review of topical antibiotics was shown to be effective in providing symptomatic relief and clearing bacteria for individuals with anterior blepharitis. Topical steroids provided some symptomatic relief but were ineffective in clearing bacteria from the eyelids. Lid hygiene measures such as warm compresses and lid scrubs were found to be effective in providing symptomatic relief for participants with anterior and posterior blepharitis
• Soften lid margin debris and oils: Place a very warm wet compress such as a warm wet washcloth over the closed eyelids for five minutes Re-wet and reapply it as it cools. This warms, softens, and loosens crusty and oily eyelid gland deposits
• Remove lid margin debris: Immediately after, gently wash the eyelids with a warm, wet, soapy washcloth to remove accumulated debris. Use diluted non-burning baby shampoo. Gently and repeatedly rub along the lid margins while eyes are closed.
• Antibiotics (if prescribed): To reduce lid margin bacteria to help control blepharitis caused by a bacterial infection, antibiotics such as erythromycin or sulfacetamide may be used via eye drops, cream, or ointment on the eyelid margin.
• Steroid eye drops/ointments. Eye drops or ointments containing corticosteroids, sometimes combined with antibiotics, can help control eye and eyelid inflammation.
• Treat underlying conditions. Blepharitis caused by seborrhea dermatitis, rosacea, or other diseases may be controlled by treating the underlying disease.
• Eye make-up should be discontinued while inflammation is present
• Dandruff shampoo. If dandruff is contributing to the blepharitis, using a dandruff-controlling shampoo may relieve blepharitis symptoms.