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What is blepharitis? Blepharitis is a very common infection of the eyelids. Bacteria which normally live on our skin produce irritating chemicals. Special tear glands, called meibomian glands, which are located in the eyelids, become blocked. Since these glands help to make our tears, blepharitis results in the production of abnormal tears. This is not a lack of tears, but tears which are of poor quality. Blepharitis is often associated with skin problems such as dandruff and dermatitis.
Severe blepharitis The edges (rims) of the eyelids are red and the eyelashes are stuck together by little crusts. The whites of the eyes are often red and sore. In the mornings the eyelids stick together, sometimes with a yellow discharge. These changes cause the eyes to be sore and irritable, with a gritty foreign body feeling. Watering is common.
No, it is not serious, and only very rarely causes any permanent damage to the eyes. However, blepharitis is a very persistent problem. (Blepharitis which is confined to the eyelid(s) on one side only should however be viewed with suspicion as very rare tumours can mimic blepharitis and lead to misdiagnosis).
Yes, though treatment usually can only control the problem and cannot eradicate it altogether.
The chief treatment is massage of the eyelids, using soft pads and hot water. You should buy some cotton pads or balls. Boil up some water and pour the water into a bowl. When the water has cooled enough for you to be able to touch it without burning your skin, but before it is cold, soak a pad in the water and press it firmly against your closed eyelids. You will need to press quite firmly, for about a minute. Finally, use the pad to stroke your eyelashes, in an up-down then side-to-side manner.
The hot water melts the tears stuck in the blocked up tear glands. Along with the pressure, this helps to unblock the glands, so that your tears become normal. Wiping the eyelashes gets rid of the crusts and the bacteria.
Depending on how bad your blepharitis is, you may need to massage the eyelids up to twice a day regularly.
In addition to regular massage, an antibiotic ointment e.g. Chloramphenicol, rubbed into the lashes at night, can clear the infection. A course of ointment, usually for a month, can be repeated several times a year. Ointments/drops containing steroids should not be used unless prescribed by an ophthalmologist. Since blepharitis causes tears to be abnormal, artificial tears can give relief from irritation, even when your eyes are watering (eyes can water as a reflex reaction to a basic dry eye problem or tear film abnormality). These should be used 3-4 times a day at least to prevent symptoms rather than to just relieve symptoms. There is a large variety of artificial tear preparations to choose from: Preservative free: Celluvisc, Minims artificial tears (these are more expensive but should be used when artificial tears are required more than 4 times a day). With preservatives: Systane, Viscotears, Hypotears, Liquifilm tears, SNO tears Lacrilube ointment is very effective at night but can cause blurring of vision in the morning.
Chalazion (meibomian cyst) and stye are two very similar lumps on your eyelid. What is a Chalazion?
A chalazion is a blocked up, inflamed meibomian gland. Your meibomian glands are located in your eyelids. They produce an oily secretion which slows the evaporation of your tear film. They have tiny pin-point openings along the length of your eyelids, behind the line of your eyelashes. Sometimes a meibomian gland gets blocked up. It begins to swell and may become infected. What is the Treatment? An infected gland is a boil-like swelling of the eyelid. It is treated with antibiotics, usually an ointment, sometimes as tablets. If it is about to burst, warm compresses can help the pus to come out. Sometimes your ophthalmologist will lance the boil, under a local anaesthetic injection. Very often the infection rapidly disappears, but it leaves behind an unsightly lump. If this is big enough, it can easily be removed, again under a local anaesthetic injection. What is a Stye? A stye is an infection of an eyelash follicle. It resembles a yellow-headed spot.
Antibiotic ointment is usually sufficient to get rid of a stye and prevents it spreading to other eyelashes. In most cases there is no special cause, and the chalazion or stye is a one-off. Diabetes as a possible cause should be excluded and this is easily done by testing a blood or urine sample.
Sometimes these problems can be recurrent. People with blepharitis are especially susceptible. Blepharitis can be caused by certain skin complaints, such as rosacea, dermatitis and dandruff.
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