Blepharitis

Blepharitis is inflammation of the of eyelid rims, which then become red and swollen. It can develop at any age but is more common in young children and people over 50. Blepharitis normally affects both eyes and is long term; the condition can come back without a structured maintenance regime

There are three main types of Blepharitis:

• Anterior Blepharitis affects the outside edge of your eyelids near your lashes. It may be caused by staphylococcal bacteria or seborrhoeic dermatitis (similar to dandruff).

• Posterior Blepharitis affects meibomian glands, which are found on the lid margin. It is often associated with rosacea or acne.

• Mixed anterior and posterior Blepharitis, which is a combination of the above.

Other types of Blepharitis are Angular and Parasitic.

• Crusting around the base of the eyelashes

• Redness of the eyelids or eyelid margins

• Dry eyes

• Burning sensation of the eyes

• Gritty feeling in the eyes

• Flakes on the eyelids

• Blurring of the vision

• Loss of eyelashes or ingrowing eyelashes

• Styes

• Small ulcers on the eyelids

• Meibomian gland dysfunction (MGD) – inflammation of oil secreting glands on the eyelid margin

• Bacterial eyelid infection

• Fungal eyelid infection

• Dry eyes

• Infection (Moraxella or staph. aureus)

• Parasites (Demodex eyelash mites or phthiriasis pubic louse)

• Blepharitis is also associated with skin conditions, such as rosacea (including in the eyes), acne, eczema, dandruff and psoriasis.

Blepharitis and dry eyes often occur in unison, which can make it difficult to decide which condition caused the other. Some researchers believe these two conditions may be one chronic eye problem known as dry eye blepharitis syndrome (DEBS).

Blepharitis usually occurs with an overgrowth of bacteria along the eyelid margins and eyelash bases; they end up producing a biofilm. The biofilm bacteria produce exotoxins that cause inflammation to meibomian glands (meibomian gland dysfunction), produce crusty plaques, and feed Demodex lash mites increasing inflammation of the eyelids.

Blepharitis is a chronic condition and will reoccur, a daily routine is key to maintain the condition.

1. Cleaning your eyelids DAILY with special wipes, we like the preservative-free blephaclean wipes (other brands are available). We have found this to be more effective then baby shampoo and sodium bicarbonate.

2. Lubricating eye drops or eye gels, to assist the dry eyes symptoms

3. DAILY hot compresses and lid massage. Using a heated eye bag (such as the eye doctor) to gently warm your eyelids and then followed with circular massaging of the eyelid rims to help treat the meibomian gland dysfunction.

4. Omega 3 supplements to reduce symptoms of dry eyes and Blepharitis

5. Cleansing and moisturising your skin especially if you have a skin condition. If you are prone to Demodex mites make sure your face wash contains tea tree to help reduce the Demodex mite population

6. Keeping your hair clean with the appropriate shampoo. Such as anti-dandruff or anti yeast dependent on your skin condition

7. Antibiotics eye ointments or drops for more serious inflammation

8. Mild steroid drops for corneal or conjunctival inflammation associated with Blepharitis, these are usually prescribed by an ophthalmologist

9. Oral antibiotics for severe inflammation that cannot be controlled with the methods above, usually prescribed by your ophthalmologist.

Other treatments: Electromechanical lid margin to remove bacteria, biofilm and Demodex mites from your eyelids and open blocked meibomian glands.

Thermal pulsation, to melt and remove blockage from the meibomian glands.  Intense pulsed light (IPL) therapy to unblock meibomian glands.

Always notify us of any allergies you may have. If your condition becomes worse you must contact your optician, ophthalmologist or GP.