| Blepharitis is an inflammation of the eyelid that is often uncomfortable for the patient and difficult for the doctor to treat.
Blepharitis occurs in many forms, including anterior and posterior. Anterior blepharitis appears on the outside front of the eyelid where the eyelashes are located. The anterior form is caused by bacteria, Staphylococcus, and by a chronic skin condition known as seborrheic disease, or common dandruff. Posterior blepharitis affects the inner eyelid where the lid meets the eye. It occurs when oil glands along the eyelid stop working properly, often when a person also has acne rosacea or seborrheic disease.
Symptoms include:
- Eyelids that are red, itchy, irritated or swollen
- Crusty eyelids or eyelashes upon awakening
- Dry eyes
- Sensitivity to light
- A sandy, scratchy or burning feeling in the eyes
- Eye fatigue
- Blurred vision
Because blepharitis is a chronic condition, treatment usually controls the symptoms but does not make the condition go away.
The first step in treatment is to keep the eyelids clean and free of crusts, to avoid rubbing the eyes, and to always wash hands before touching the eyes. To loosen crusts and help open clogged oil glands, a warm compress using a soft face cloth should be applied to the eyelids for 5 to 10 minutes, twice a day. After the condition is brought under control, a warm compress can be used once a day, usually in the morning.
After the warm compress, gently scrub the eyelid with the face cloth or a cotton swab soaked in diluted baby (no tears) shampoo.
Between the warm compress and gentle scrubbing, patients with posterior blepharitis should also massage the eyelids to help move oil accumulated in the glands. If scalp dandruff is present, a dandruff shampoo is recommended to help control that condition. If acne rosacea is present, a doctor should treat that condition at the same time. If the blepharitis is severe, topical or systemic antibiotics may be prescribed.
Complications from blepharitis include styes (a red, tender bump on the eyelid); chalazion (a sometimes painless, firm bump that follows a sty); and tear problems (excess tearing or dry eye). Tear problems can lead to cornea infections because tears help keep the eye healthy.
It is important to have your eye condition diagnosed by an ophthalmologist, since blepharitis can be confused with other conditions. These other conditions include: ocular rosacea, episcleritis, herpetic keratitis, or conjunctivitis (pink eye).
by James P. McCulley, M.D.
Chairman, Department of Ophthalmology
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