Blepharitis
What is blepharitis?
Blepharitis is the inflammation of the eyelash follicles along the edge of both the upper and lower eyelids. It is usually found in both eyes but can affect one eye or lid disproportionately. The inflammation is usually caused by bacterial infections in the glands of the eyelids. Some other causes are:
- Rosacea (Adult acne)
- Scalp dandruff
- Trauma caused by smoke, chemical fumes or smog
- Drug allergies or sensitivities
- Lice on the eyelid
- Eczema-like dermatitis
Subtypes include:
- Anterior Blepharitis affects the outside front of the eyelid, where the eyelashes are attached.
- Posterior Blepharitis affects the inner eyelid (the moist part that makes contact with the eye)
Symptoms
Symptoms that can mimic conjunctivitis include
- Mild-moderate eye and eyelid discomfort (itch or sensation of ‘something in the eye’
- Eye and or eyelid redness
- Loss of eyelashes
- Excessive blinking or tearing
- Crusting or ocular discharge, which can occasionally cause the eyelids to stick together during sleep.
Usually there is no blurring or any change in vision.
If Blepharitis is left untreated, complications such as: conjunctivitis, Meibomian cysts (small abscess in the eyelid), cornea ulcers, eyelashes that turn in and irritate the eye or an intolerance to contact lenses may develop.
Management
Treatment for blepharitis can be ongoing as in some cases treatment is focused on optimisation to a manageable level and it cannot be cured. Some patients may not have any signs and symptoms for months; even years and it may reappear again in a cyclical nature.
Your ophthalmologist will initially attempt to treat the infection with antibiotic ointment or drops if an infection is suspected and then advise a proper longer term cleaning regime of the eye area (aka ‘lid hygiene’), to aid in preventing it reoccurring. This includes
- Warm compresses
- Eyelid scrubs and
- Application of antibiotic ointment
Patients must be cautioned that blepharitis is typically a chronic disease and that eyelid hygiene may need to be continued indefinitely. When the condition is under control, once-daily eyelid scrubs may be sufficient to keep the condition controlled.
Important Notes
- Blepharitis can mimic conjunctivitis with symptoms including eye and eyelid redness, tearing, irritation, crusting and discharge
- Blepharitis is often related to infection, but may be related to other skin conditions, medications or irritants
- Untreated blepharitis can lead to corneal ulcers, intolerance of contact lenses, inward turning eyelashes or cysts (aka chalazions or ‘styes’)
- Treatment usually involves lid hygiene – warm compresses, eyelid scrubs and application of an antibiotic ointment. Treatment may be long term to prevent recurrence or cycles of symptoms