A common and often persistent condition, blepharitis (blef-uh-RYE-tus) refers to an inflammation of the eyelids.  Blepharitis usually results from poor eyelid hygiene, a low-grade bacterial infection and/or irregular functioning of the oil glands. It rarely results in long-term damage to vision, but it can cause both ingrown and the loss of eyelashes. The ingrown eyelashes cause further irritation to the eye and can lead to corneal scarring if left untreated.  In severe cases, there is a loss of pigment in the eyelashes, causing them to turn white or grey.   Styes and chalazia are another common side effect of blepharitis.  These result when the bacterial debris clogs the pores of the eyelids and cause the glandular secretions to back up.  Blepharitis is also often associated with dry eye syndrome.

People who experience skin conditions including dandruff, oily skin, seborrheic dermatitis, eczema, rosacea, or psoriasis are more susceptible to blepharitis. People exposed to chemical fumes, smog, smoke and other irritants or those reacting to medication might experience chronic cases of blepharitis.  Although more often seen in adults, it does affect children as well. Like dandruff, blepharitis tends to be a chronic condition without a cure, however, treatment does exist to manage blepharitis and to improve eyelid hygiene. 

There are two main types of blepharitis; seborrheic and staphylococcal. Gland dysfunction brought on by hormones, one’s general health or lack thereof, stress and poor nutrition are common causes of seborrheic blepharitis. Dandruff of the scalp and other skin conditions usually accompany it. The second type is staphylococcal blepharitis, caused by the staphylococcus bacteria. This condition can result in the loss of eyelashes, enlarged blood vessels around the lids and crusting around the eyes 

Signs and Symptoms 

Common symptoms include redness around the edge of the eyelids and/or scaly as well as crusty matter on the eyelids or lashes, especially noticeable upon waking. People also experience swollen eyes, greasy flakes or scales at the base of the eyelashes or on the eyelids, loss of or ingrown eyelashes and excessive tearing. Symptoms include feeling that something is in the eye when blinking, itching or burning eyes, sensitivity to light and/or irritation of the skin at the edges of the eyelids.  

Treatment 

Treatment of blepharitis often requires a program of eyelid hygiene, including eyelid cleansing at specific intervals. Regular washing of your hands, face and scalp with soap will help control mild cases. For cases that are stubborn, warm compresses and eyelid scrubs are recommended. Warm compresses should be applied for approximately five minutes; a clean facecloth run under warm water or microwaveable heat packs can be used.  Special pads are available for eyelid scrubs that decrease the amount of debris, flaking skin and eyelid redness. Use warm compresses followed by eyelid scrubs once or twice a day. In some cases, it might take up to eight weeks before there is an improvement. Ongoing treatment is often necessary to control the condition. Your optometrist might also prescribe an antibiotic or an antibiotic- corticosteroid combination depending on the severity of the condition.  Avoid wearing makeup and replace your makeup during flare-ups of blepharitis. This is important as bacteria can survive in makeup cases, on pencils and, especially, on mascara. If you wear contact lenses, it is important to keep the blepharitis under control as it can increase your risk for infection, and you should not wear your contact lenses while you have symptoms.

For more information or to determine if you have blepharitis, visit your optometrist.

Written by Cowichan

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