Blepharitis

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Blepharitis

What is blepharitis?

Blepharitis is an inflammation of the edge of the eyelid that can be classified as:

  • Anterior: Affects the outermost area around the base of the eyelashes.
  • Posterior: Affects the innermost part in contact with the eye.
  • Mixed: A combination of anterior and posterior blepharitis.

It may be associated with skin disorders such as rosacea, seborrhoeic dermatitis, and psoriasis, though the cause is not always identifiable.

Blepharitis is a common condition, affecting about 30% of the population. It is often linked to dry eye, as it worsens tear quality.

What causes it?

Anterior Blepharitis

  • Caused by excess oil or bacterial proliferation.
  • May result from infections caused by the microorganism Demodex.

Posterior Blepharitis

  • Results from malfunction of the Meibomian glands, which may become:
    • Blocked.
    • Damaged.
    • Overactive, producing excessive oil.

These glands produce the lipid layer of tears, which stabilizes the tear film. Dysfunction leads to:

  • Tear film instability.
  • Inflammation and damage to the ocular surface.

Common Causes

  • Excessive contact lens use.
  • Hormonal changes (e.g., adolescence, menopause).
  • Ageing.
  • Treatments for skin diseases.
  • Chemotherapy.

How can it be prevented?

Maintaining careful and regular eyelid hygiene is key. Just as brushing your teeth daily prevents oral health problems, daily eyelid cleaning reduces bacteria and oil buildup, minimizing the risk of blepharitis.

Symptoms

The severity of symptoms can vary widely:

  • Mild cases: May go unnoticed or cause mild discomfort.
  • Severe cases: Can lead to complications, particularly in the cornea, and even affect vision.

Common Symptoms

  • Eye redness.
  • Foreign body sensation.
  • Itching or stinging.
  • Skin flakes between the eyelashes.
  • Ocular dryness.
  • Photophobia (sensitivity to light).
  • Excessive blinking.
  • Blurred vision.
  • Pain.

In many cases, clinical signs are detected by an ophthalmologist before the patient notices symptoms, which may develop late.

Associated Treatments

Treatment focuses on consistent daily eyelid hygiene:

  1. Warm Compresses:

    • Apply warm swabs to closed eyelids for 5 minutes.

  2. Lid Massage:

    • Massage vertically (towards the root of the eyelashes) to release bacteria and oil.

  3. Cleaning:

    • Use a soap solution or special wipes to clean the eyelids.

Additional Treatments

  • Topical medications: Antibiotic and/or anti-inflammatory eye drops may be prescribed.
  • In-office procedures: For severe cases, certain treatments can be applied by an ophthalmologist to address blepharitis and associated dry eye problems.