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Blepharitis

Meibomian inflammation results in inflammation of the eye lid margin.

This is a common condition that causes inflammation of the eyelids and which is quite difficult to manage because it tends to recur.

Mainly caused by staphylococcus infection and scalp dandruff.

Blepharitis symptoms include burning sensation, the feeling that there is something in the eye, excessive tearing, blurred vision, redness of the eye, light sensitivity, red and swollen eyelids, dry eye and sometimes crusting of the eyelashes on awakening.

Symptoms include itching and tearing of the eyes, and crusting of the eye lashes.

Treatment includes warm compresses, eye washes and topical antibiotic ointment.

Characterized by chronic inflammation of the eyelid.

Onset can be acute, resolving without treatment within 2–4 weeks.

Generally is a long standing inflammation.

Varies in severity.

Classified as seborrhoeic, staphylococcal, mixed, posterior or meibomitis, or parasitic.

Signs and symptoms that are associated with the chronic inflammation include:

Redness of the eyelids

Flaking of skin on the lids

Crusting at the lid margins

Crusting worse in the morning

Infection of the eyelash follicle/sebaceous gland (hordeolum) may occur

Red eyes

Gritty sensation of the eye or foreign-body sensation.

Eye itching.

The eyelids may become red and may have ulcerations which may bleed.

Does not tend to cause problems with vision, but due to a poor tear film, blurred vision may occur.

Eye redness and swelling tend to occur in more severe cases.

Blepharitis due to an allergy can cause dark lids, referred to as “allergic shiner”.

Blepharitis due to an allergy tends to be more frequent in children.

Infectious blepharitis is accompanied by a yellow- or green-colored mucus discharge.

Infectious blepharitis can lead to matting and stuck lids, especially in the morning.

Rarely blepharitis symptoms include sensitivity to light, eyelashes that grow abnormally, loss of eyelashes, frothy or bubbly tears,

Often misdiagnosed as conjunctivitis.

When blepharitis localizes in the skin of the eyelids it may cause styes or chalazion.

Treatment normally consists in maintaining a good hygiene of the eye and holding warm compresses on the affected eyelid to remove the crusts.

Gently scrubbing the eyelid with the warm compresses ease the healing process.

In more serious cases, antibiotics may be prescribed.

Pain is not common.

Chronic blepharitis may have a negative effect upon vision.

Infectious blepharitis can ulcers that may bleed.

Contact lens users may have more trouble because the lenses cause further irritation to the eye.

Patients experience a foreign body sensation, matting, and burning.

A a ring-like formation around the lash shaft is a sign of this condition, and other findings include loss of eyelashes or broken eyelashes.

Staphylococcal blepharitis commonly recurrent, and incidence varies with climate.

Staphylococcal blepharitis may start in childhood and persist into adulthood.

Staphylococcal blepharitis is normally treated with ophthalmic antibiotics such as chloramphenicol ointment.

Fusidic acid is among the choices of antibiotics in cases when chloramphenicol is contraindicated.

Antibiotics are given for at least four to six weeks, and a short course of topical steroids are usually administered to control the inflammation.

The infection is also treated with eyelid hygiene consisting of cleaning of the eyelid, removing crusts and debris.

Posterior blepharitis refers to inflammation of the eyelids secondary to dysfunction of the meibomian glands.

Posterior blepharitis is a bilateral chronic condition involving the lids manifested by inflammation and plugging of the meibomian orifices and production of abnormal secretion upon pressure over the glands.

Posterior blepharitis may be associated with skin rosacea.

Daily routine of lid margin hygiene should be continued for life to avoid relapses as blepharitis is often a chronic condition.

Antibiotic ophthalmic ointment should be used prior to bed time as opposed to in the morning to avoid blurry vision.

Mild massage to empty glands located at the lid margin including Meibomian, Zeis, and Moll glands is suggested.

Allergic responses to dust mite feces and otherwise allergens can cause lid inflammation, ocular irritation, and dry eyes.

Ocular antihistamines bring relief to patients whose lid inflammation is caused by allergies.

Omega-3 supplementation in the form of fish oil or flaxseed reduces the symptoms of blepharitis.

A Cochrane Systematic Review revealed topical antibiotics are effective in providing symptomatic relief and clearing bacteria for individuals with anterior blepharitis.

Topical steroids provide symptomatic relief but were ineffective in clearing bacteria from the eyelids.

Lid hygiene measures are effective in providing symptomatic relief for participants with anterior and posterior blepharitis.

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