Blepharitis

Blepharitis is the inflammation of the eyelid margins and can be catagorised into two forms; anterior and posterior Blepharitis.

Anterior Blepharitis

Affecting the front of the eyelid margin near the eyelash roots, it is caused by bacteria which lives on our skin. They produce a toxin which is irritating to us and causes inflammation. The lid margins will often appear ‘crusty’ and have an appearance similar to dandruff. The eyelids can also become red, itchy and slightly swollen.

Posterior Blepharitis

Caused when the meibomian glands located in the eyelid become obstructed. The glands produce an oily secretion which forms the oily layer of the tear film, if they become blocked the secretions reduce in volume and quality. This leads to irritation of the lid margin as well as dry eye due to the poor tear film.

Who gets Blepharitis and what are the symptoms?

Blepharitis is very common and can occur at any age, although most suffers are over the age of 50.

Occasionally patients can suffer from Blepharitis and not have any symptoms; however, most people do. The common symptoms include:

• Irritation of the eyelids and/or eyes
• Redness of the eyes
• Sore eyelids – sometimes red and swollen lid margins
• Crusting of the eyelid margins
• Eyelids may stick together on waking in mornings
• Burning and tearing of the eyes
• Gritty sensation in eyes
• Pain on looking at bright lights (photophobia)
• Small eyelid margin cysts

How can Blepharitis be diagnosed?

Blepharitis is usually diagnosed by a combination of clinical history and examination of the lid margin with a slit lamp microscope. It can be diagnosed by an Optometrist or a GP.

How can Blepharitis be treated?

As yet there is not a single cure for Blepharitis. There are several methods Optometrists can use to help patients manage the condition by reducing symptoms. There are several treatments available, but there isn’t one definitively better than another.

Lid Margin Cleaning

Improved lid margin hygiene can help with both forms of Blepharitis. It is recommended you:

• Soak a clean flannel in hot, clean tap water (boiled, sterile water isn’t required). Don’t make the water too hot
• Close the eye and gently apply pressure with the flannel for 30 seconds to 1 minute, or until the flannel goes cool.
• Wet the flannel again in hot, clean tap water
• Use the flannel to scrub along the top and bottom lid margins, being sure to clean the area around the roots or the lashes. Continue for 30 seconds to 1 minute.
• Repeat for the other eye.

This cleaning regimen should be repeated twice a day for a minimum of one month. At the end of this time most patients will notice a decline in symptoms. If the symptoms do not subside our Optometrist will be able to advice you further.

You can further reduce symptoms by:

• Avoiding irritants – chemical irritants such as eye drop preservatives and makeup can cause Blepharitis.
• Dietary changes – some evidence suggests omega 3 oils can improve the quality of meibomian gland secretions.
• Taking antibiotics – if there is an associated skin condition such as seborrheic dermatitis, or rosacea, or a severe bacterial anterior inflammation your GP may prescribe antibiotic eye ointment or tablets.