Blepharitis

Dr. Burke is one of Cincinnati’s most trusted resources concerning blepharitis.

What is Blepharitis?

Blepharitis is a common and persistent inflammation of the eyelids. The chief symptoms of blepharitis are irritation, burning, and itching of the lid margins. The eyelid margins may be red, scaly, and sometimes swollen. Many scales of greasy granulations can be seen clinging to the base of the eyelashes and accumulating on the skin edge of the lid margins of both the lower and upper lids. Occasionally, more serious cases cause the eye to be red and induce inflammation of the cornea (clear “window” of the eye). Corneal inflammation, or keratitis, may cause additional symptoms of tearing, light sensitivity, and foreign body sensation. Blepharitis is often linked to the development of styes and chalazia.

Who gets Blepharitis?

This condition frequently occurs in people who have a tendency towards oily skin, seborrheic dermatitis, or dandruff. Blepharitis can begin at any age. One especially common time is pre-puberty and adolescence when hormones and oil glands are very active. Blepharitis often runs in families.

Why does Blepharitis happen?

The two most common reasons for the development of blepharitis are an over-growth of bacteria on the skin at the base of the eyelashes or over-activity of the eyelids’ oil glands — or a combination of both of them. Bacteria reside on the surface of everyone’s skin, but in certain susceptible individuals they thrive in the skin at the base of the eyelashes. The resulting infection, often associated with over-activity of the nearby oil glands of the eyelid, causes dandruff-like scales and crusty-like debris to form along the eyelashes and eyelid margins.

How is Blepharitis treated?

Eyelid hygiene is essential to the treatment of blepharitis. Follow these steps:

STEP 1. Wetting the eyelid margins and eyelashes. This will soften and loosen scales and debris. More importantly, it helps liquefy the oily secretions from the eyelid’s oil glands that help prevent the development of a chalazion or stye.

• At the sink, wet a washcloth with very warm water, wring it out, and place over the closed eyelid for one minute. Repeat 2 or 3 times for a few minutes.
• In the shower or bathtub, allow the warm water to run continuously over the face and closed eyelids for a one minutes.

STEP 2. Cleaning the lid margins. This will help remove the debris thus returning the eyelid to a healthier balance between the skin bacteria and oil glands.

• Place a small amount of baby (tear free) shampoo in the palm of your hand. Mix with a small amount of water. Rub the hands together to form lots of suds. OcuSOFT Lid Scrub is an excellent prepared product in the eye-care section of most pharmacies.
• Scrub the base of the eyelids and eyelashes with the suds softly and carefully in a side-to-side motion (not up and down) for about 30 seconds.
• Rinse the eyelids and lashes with warm tap water.

What may be used in severe cases?

In those cases that are not managed by steps one and two above or where the blepharitis is not discovered early and the infection has progressed, the use of antibiotics is often necessary. In these cases, the additional step is added:

STEP 3. Antibiotics for infection.

• Perform steps 1 and 2 above.
• Antibiotic ointment medication, often mixed with a mild steroid to decrease inflammation, is gently massaged onto the lid margins and the base of the eyelashes with the tip of the finger.
• For serious infections not responsive to ointment or for those individuals whose blepharitis is linked to recurrent chalazia, oral antibiotics may also be required for short or long-term prophylactic use.

Can blepharitis be cured?

For those susceptible to blepharitis, the condition tends to be a chronic condition that cannot be cured. However, blepharitis can usually be controlled through proper eyelid hygiene utilizing the routine use of the cleansing steps 1 and 2 listed above.

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