Blepharitis is an inflammation of the eyelids, especially on the eyelid margin. This is a common disease and may be caused by a mild microbial infection or a dermatologic disorder.
Blepharitis occurs in two forms: anterior blepharitis and posterior blepharitis. In the anterior blepharitis, the outside front edge of the eyelid is engaged, which is where the eyelashes meet each other. Two common causes of anterior blepharitis are microbial infections and seborrhea. In the posterior blepharitis, caused by the blockage of the oil glands of the eyelids (meibomian glands), the inside of the eyelid is engaged. Two skin diseases that cause posterior blepharitis include acne rosacea and dandruff.
Blepharitis Signs and Symptoms
Regardless of the type of blepharitis, symptoms that are commonly seen in blepharitis include itching, irritation, tearing, foreign body sensation, crusting (on the eyelashes, on the corner of the eye or on the eyelid), dryness, and redness of the eyelid margins.
In case of having such symptoms, it is necessary to see an ophthalmologist. If blepharitis is not treated, it will cause thickened lid margins, dilated capillaries, trichiasis (in-growth of the eyelashes), madarosis, ectropion (outward turn of the eyelids) and entropion (inward turning of the eyelid). It may also lead to conditions and complications on the conjunctival and corneal surfaces.
Blephartitis complete treatment may be difficult, because it usually recurs. The treatment depends on the type of blephartitis, and may include applying warm compresses on the eyelids, cleaning them, using antibiotics and/or eyelash massage. If blepharitis causes dry eyes, it may be necessary to use artificial tear drops or lubricant ointments (which reduce the friction between the eyelids and the ocular surface). Sometimes corticosteroids are also used to control inflammation, but their long-term use is impossible due to the resulting complications. The warm compress loosens the eye crusts, so they can be removed more easily while cleaning the eyelids.
Warm compress also melts and loosens the plaques blocking the eyelid oil glands. The obstruction of these glands causes inflammation. First, wash your hands and put a towel, wet with warm water, on your closed eyes. At the beginning of the treatment, the ophthalmologist may prescribe it 4 times a day, 5 minutes each time. Afterwards, warm compress may be sufficient once a day, for a few minutes.
Cleaning the eyelids is necessary for blepharitis treatment. This is done by massaging the eyelids with a diluted baby shampoo. In order to massage the eyelids, first wash your hands and massage the eyelid margins and the area around your eyelashes with your fingers, cotton buds, gauze, or a clean towel and then thoroughly rinse it with lukewarm water.
In some cases, administering antibiotics as topical ointment or oral treatment is necessary.
If there is also dysfunction in the eyelid oil glands, warm compress and eyelid massage are necessary in order to remove the excess fat. The massage procedure should be done as instructed by the ophthalmologist.
Since blepharitis tends to be chronic, treatment may take long. If the patient uses contact lenses, depending on the type of blepharitis, it may be necessary not to wear the lenses, during blepharitis treatment and even afterwards. For some of these patients, high permeability lenses are prescribed, while others are recommended to increase lens replacement times. Some patients will find it difficult to use lenses and should explore other methods for correcting their refractive errors.
It is also preferable not to use cosmetics, as it may disrupt the massage therapy and cleaning of the eyelids. In some cases of blepharitis, it is recommended that the patients use anti-dandruff shampoos for the washing their heads and eyebrows.