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Eye Conditions: Blepharitis

Overview

Blepharitis (blef-uh-RYE-tus) is a general term for an inflammation of the eyelid and eyelashes. It is among the most common and stubborn ophthalmic conditions, usually resulting from poor eyelid hygiene, a low-grade bacterial infection (usually staphylococcal), an allergic reaction, and/or abnormalities in oil gland function such as plugged glands or over-production. Occasionally, it results from lice infestation.

Although usually not serious or causing long-term damage to vision, blepharitis can be difficult to treat and is a chronic problem for some. Those most susceptible include people with other skin conditions such as rosacea, acne, eczema, seborrheic dermatitis, psoriasis, oily skin or dandruff, as well as those infected with the herpes simplex virus. Chronic cases may also be related to exposure to chemical fumes, smoke, smog and other irritants or reactions to medications.

Blepharitis is also a cause or effect of several ocular conditions, including dry eye, chalazion, conjunctivitis and keratitis, and can result in the loss of or ingrown eyelashes. It is not contagious and although seen more commonly in adults, it also affects children.

Like some other skin condition, blepharitis can be controlled but not cured. The main goals in treating it is to reduce the bacteria counts along the lid margin and open plugged glands — accomplished with good eyelid hygiene and regularly applying a warm washcloth or other form of heat to eyelids.

Symptoms

The most common symptoms include redness of the lid margins and the eye and/or mucus or crusty matter on the eyelids or on lashes. These symptoms tend to be worse upon awakening, and may wax and wane throughout the day. Other symptoms include:

  • Greasy flakes or scales on the eyelids or at the base of eyelashes
  • A sensation that something is in the eye when blinking
  • Swollen eyes
  • Itching or burning
  • Missing or ingrown lashes
  • Scarring of the eyelid margins or small, oozing sores at the base of “missing” eyelashes
  • Irritation or breakdown of the skin along the edges of the eyelids
  • Excessive tearing
  • Sensitivity to light

Prevention

Good eyelid hygiene is essential for preventing recurrences and severity. Besides regularly washing your hands, entire face and scalp with soap/shampoo, place a clean washcloth that’s been moistened in warm water on your eyelids for about 5 minutes several times a week.

Those with especially oily skin may also benefit from weekly eyelid “scrubs” with a tearless baby shampoo diluted in warm water. This helps decrease the amount of flaking skin and oil in the area. After washing hands well, mix about ½ cap of baby shampoo in about 6 ounces of water and closing one eye, use a clean washcloth (wrapped around your index finger) or cotton-tipped applicator eye to rub the solution back and forth across the eyelashes and the edge of the eyelid. Rinse that eye with clear, cool water, and repeat with the other eye, using a different washcloth or applicator.

Treatment

Preventative measures such as eyelid soaks and scrubs are often used to treat blepharitis and remove crusts. During outbreaks, eyelid soaks should be extended to 15-20 minutes, three-four times a day, and scrubs should be done at least several times a week (and perhaps daily). Your eye care provider may also recommend substituting diluted baby shampoo with commercial eyelid cleansers such as OCuSOFT® Lid Scrub and prescribe you an antibiotic such as doxycycline.