Conditions: Blepharitis & Chalazion

Font Size:

What is blepharitis?

Blepharitis is a very common inflammation of the eyelids. Bacteria which normally live on our skin are attracted to crusts around the base of the eyelashes and produce chemicals which irritate the eyes.causing symptoms of itching, irritation and burning. Special tear glands, called meibomian glands, which are located in the eyelids, become blocked. Since these glands help to make our tears and prevent them from evaporating too quickly, 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

How do I know if I have blepharitis?

The edges (rims) of the eyelids are red and the eyelashes are stuck together by tiny 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 due to the reflex production of excess tears is common.

Is it serious?

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).

Can it be treated?

Yes, though treatment usually can only control the problem and cannot eradicate it altogether.

What is the treatment?

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.

Better (but more expensive) wipes which are specially designed for this purpose are called “Blephaclean wipes”. For further information about these wipes with details of how to order them go to:

http://www.spectrumthea.co.uk/apps/content/HTML/ViewContent.aspx?id=9

What is the purpose of the hot water massage?

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.

A much better solution is the use of the “Eye Bag” which is specially designed to improve meibomian gland function and to sooth the symptoms. For further information about the “Eye Bag” go to: http://www.eyebag.co.uk/

Wiping the eyelashes gets rid of the crusts and the bacteria.

How often should I do this?

Depending on how bad your blepharitis is, you may need to massage the eyelids up to twice a day regularly.

Is that all I have to do?

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: Hyabak drops, Celluvisc, Minims artificial tears, Systane drops preservative free, Viscotears preservative free, or Liquifilm tears preservative free (these are all more expensive but should be used when artificial tears are required more than 4 times a day or where there is a known allergy to preservatives).

With preservatives: Systane, Viscotears, Hypotears, Liquifilm tears, SNO tears, Optive,
Lacrilube ointment is very effective, particularly when used at bedtime but it can cause blurring of vision in the morning.

« Return to Conditions Index

back to top

---

Chalazion (meibomian cyst) and stye are two very similar lumps on your eyelid.

What is a Chalazion?

	A typical 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.

What is the Treatment for a Stye?

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.

Why Do People Get a Chalazion or a Stye?

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.

« Return to Conditions Index

back to top