Blepharitis

Blepharitis is an inflammation that occurs along the edges of the eyelids. It is a very common condition and can affect people of any age. The symptoms can be troublesome, and sometimes difficult to treat, but in general the condition is not dangerous to the overall health of your eyes.

 

Within each eyelid, there are many small oil glands (meibomian glands), which open up at the base of the eyelashes. The oils they secrete are an important part of the tear film, which keeps the surface of the eye moist and lubricated. In some people however, these oil glands start to produce too much. If this happens, excess oil accumulates along the edges of the eyelids, and a sticky crusty film can build up at the base of the eyelashes. This crusty layer may not be visible to the naked eye, but your eye specialist will be able to see it with the use of a low-power microscope called a slit-lamp microscope.

 

Blepharitis

Blepharitis

 

This oily film allows skin bacteria to thrive, and the combination of the sticky crust and bacterial infection causes inflammation, redness and gritty discomfort. Excess oil also disrupts the delicate balance of the tear film on the eye surface, and can cause symptoms of dry eye such as burning, stinging, itching, tired eyes, and blurred vision. Conversely, the eyes can sometimes become watery and teary. Sometimes, the oil glands can become blocked, causing a stye or chalazion, a small lump in or along the edge of an eyelid.

 

Treatment of blepharitis aims to reduce the excessive oil build-up and calm the associated inflammation. Your eye specialist will discuss methods of eyelid hygiene with you, to help the oil glands to drain and to remove excess oils from the lid margin, where your inner eyelid meets the outer lid.

 

The basic principles of lid hygiene are as follows:

 

  1. Apply a hot compress to the eyelids to open the pores and encourage the glands to drain freely. Hold the hot compress on the closed eyelids for 1–2 minutes.
  2. Gently massage the eyelids in the direction of the eyelashes to again help the glands to drain onto the surface.
  3. Then clean the lid margins to remove any crusty or sticky film. This oily build-up can really stick to the base of the eyelashes and be stubborn to remove. A moist cotton bud, cotton ball or make-up removal pad can be used to clean along the edge of the lids at the base of the lashes. A few drops of baby shampoo in some warm water will also help, or a diluted solution of bicarb soda (1 teaspoon bicarb soda in 300ml water). There are also commercial preparations that you can buy from your local chemist, such as SteriLid© or LidCare©

 

 

Your specialist may also prescribe some medication to help with the inflammation. This may be in the form of eye drops, ointment, or occasionally antibiotic tablets.

 

Blepharitis is often a chronic condition, and some people suffer from repeated attacks. Long-term treatment is aimed at prevention, as well as managing flare-ups when they occur.

 

Illustrations shown are provided courtesy of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) and Mi-Tec Publishing. The complete RANZCO patient education pamphlet is available from your ophthalmologist