Blepharitis

Blepharitis is a common condition where the edges of the eyelids (eyelid margins) become red and swollen (inflamed).

This condition can develop at any age, and symptoms can include:

• itchy, sore and red eyelids that stick together

• crusty or greasy eyelashes

• a burning, gritty sensation in your eyes

• increased sensitivity to light (photophobia)

• swollen eyelid margins

• finding contact lenses uncomfortable to wear

• abnormal eyelash growth or loss of eyelashes in severe cases

In most cases both eyes are affected, but one eye can be more affected than the other. The symptoms tend to be worse in the morning.

There are two main types of blepharitis:

Anterior Blepharitis affects the front part of the eyelid margin, near the roots of the eyelashes. It is commonly caused by bacteria that normally live on our skin, that produce an irritative toxin that causes inflammation. The lid margin often looks ‘crusty’ and when seen under a microscope, the appearance can be similar to dandruff. Anterior Blepharitis can cause the eyelids to become red, itchy and sometimes slightly swollen too.

Posterior Blepharitis is also referred to as Obstructive Meibomian Gland Disease. The meibomian glands are located within the eyelid, and the pores of the glands open onto the lid margin, behind the roots of the eyelashes. The glands normally produce a special oily secretion for the tears. The meibomian glands sometimes become inflamed and blocked, causing a reduction in amount, and disturbance in quality of the oily secretions. This can not only cause eyelid margin irritation, but also has secondary dry eye effects on the ocular surface.

Who Gets Blepharitis?

Blepharitis is very common indeed – 5% of eye problems in primary care are said to be related to blepharitis. People of any age can be sufferers, but it is more common in older people over the age of 50. It is not something ‘caught’ or inherited. The reason for some people developing blepharitis is poorly understood.

How Is Blepharitis Treated?

Unfortunately, there is not a definitive cure for blepharitis. There are many different ways clinicians have managed patients with blepharitis over the years. The fact there is not a definitive treatment is an indicator that no single treatment works significantly better than all others.

Lid Margin Cleaning

Both types of blepharitis can be helped with what is commonly referred to as ‘lid margin hygiene’. Put simply, this means regular cleaning of the lid margins.

There are three main steps to lid hygiene that should be performed once or twice a day:

• using a warm compress – to make the oil produced by the glands around your eyes more runny

• gently massaging your eyelids – to push the oils out of the glands

• cleaning your eyelids – to wipe away any excess oil and remove any crusts, bacteria, dust or grime that might have built up

Carry out this cleaning regimen twice a day for at least a month. Most people will experience a reduction in symptoms. If not, seek expert help from your optometrist who will be able to make further recommendations, or refer you to an ophthalmologist if required.

All of the staff in the practice are qualified Ocular Hygenists and able to advise you on the best and most suitable lid hygiene for your condition.

Avoid Irritants

Minimising chemical irritants that include certain eye drop preservatives and makeup can help reduce blepharitis symptoms.

Dietary Changes

There is some evidence to suggest omega 3 oils such as those in Flax-seed can improve the quality of meibomian gland secretions.

Antibiotics

Occasionally, if there is marked bacterial anterior inflammation, or if there is an associated skin condition such as seborrheic dermatitis, or even Rosacea, your optometrist may prescribe antibiotic eye ointment, or indeed oral tablets.