Blepharitis is one of the most common eye conditions Dr. Mandel treats at the Mandel Vision laser vision correction center in Manhattan. Blepharitis, like many medical diagnoses is derived from latin. The pre-fix, “blepharo”, means pertaining to the eyelids. The suffix, “-itis”, means inflammation. Thus, blepharitis technically means inflammation of the eyelids.
Symptoms of blepharitis can include:
- Watery eyes
- Red eyes
- Ocular irritation
- Itchy eyelids
- Red, inflamed eyelids
- Discharge and/or crusting of eyelashes upon awakening
- Eyelashes or eyelids sticking together
- A raw, burning sensation on the eyelids and/or eyes
There are 2 different types of blepharitis: anterior and posterior.
Anterior blepharitis affects the eyelid margins, both upper and lower, which are the parts of the eyelids where the eyelashes grow.
Causes of anterior blepharitis can include:
A bacterial infection: This type of blepharitis is not contagious, and is typically treated with an antibiotic eye drop or ointment, and accompanied by good eyelid hygiene. Hygeine includes eyelid cleansing and hot compresses. Eyelid cleansing can be accomplished by either using baby shampoo diluted with water or specialized eyelid scrubs, which are over the counter and can be purchased at any drug store.
For the hot compresses, you have two choices. You can apply a clean washcloth, wet with very warm water or a tiny red potato warmed up in the microwave and then wrapped in a clean face towel to your eyelids, with the eyes closed. The latter works best, as the potato holds in the heat longer, and the potatoes can be found in sizes that fit well on the eye. Eyelid scrubs and hot compresses (for approximately10 minutes ) may be needed 2 times a day, or more, when symptoms of blepharitis are present.
Dermatitis: This type of blepharitis is akin to dandruff of the eyelids, and is often seen in patients with seborrheic dermatitis, a skin condition that causes flaking and scaling of the skin, which can include the eyelids. Treatment for this form is usually limited to the same eyelid hygiene described above.
Microscopic mites: These mites and their waste material can clog the follicles on the eyelid margins, at the roots of the eyelashes which can cause anterior blepharitis. Although these mites are common in everyone, they don’t always cause the symptoms of blepharitis. Therefore, it’s believed that those people that do develop symptoms of this type of blephartitis have developed an allergy or sensitivity to these microscopic mites.
Posterior blepharitis is commonly referred to as meibomian blepharitis or meibomitis, and is linked to a condition called meibomian gland dysfunction (MGD), because it’s caused by dysfunction of this gland that is located inside the eyelid.
Causes of posterior blepharitis can include:
MGD: The meibomian gland, located inside the eyelid, is responsible for secreting oils that are a part of the eye’s tri-layer tear film, which helps lubricate the eye. Therefore, posterior blepharitis is a common form of dry eye syndrome, so is often accompanied by dry eye symptoms. With this type, treatment for the meibomitis may include steroid drops and/or ointment in conjunction with eyelid hygiene. In addition to the treatment for the symptoms of meibomitis, the accompanying dry eye symptoms that are a direct result of the meibomitis must be treated as well. For this, eye drops that are specifically formulated to mimic the oily layer of the tear film are recommended.
Acne rosacea: Rosacea is a skin condition that causes inflammation of the skin which appears as redness and/or pimple-like bumps of the skin, usually around the cheeks, nose, forehead and chin. Ocular rosacea can cause inflammation specifically of the eyelids and has been linked to MGD.
Some other things you can do to help keep the symptoms of blepharitis at bay, include:
- Taking oral nutritional supplements that are high in omega-3 fatty acids. This can be helpful with the posterior form of blepharitis, as it can help improve the function of the eyelid’s oil glands. Dr. Mandel recommends this mainly for our female patients.
- Using over the counter natural tears to address the symptoms of dry eye that often accompany blepharitis. These can make your eyes feel better and less irritated.
- Discontinuing your contact lenses during the acute phase of blepharitis, and then replacing your contact lenses more frequently once your eye doctor approves resuming contact lens wear.
- Discontinue, or at least minimize, the use of eye makeup (especially on the eyelid margins) during the acute phase of blepharitis. Eye makeup can contribute to the clogging of the oil glands which can exacerbate the symptoms of blepharitis and make it harder to control.
Although there is no permanent cure for blepharitis, the above mentioned treatments can help manage its symptoms. Therefore, your best defense against blepharitis and its uncomfortable symptoms is lid hygiene. This includes eyelid cleansing and hot compresses on a daily, long-term basis, even when symptoms are not present. The reason for this is that blepharitis is a chronic condition, so good eyelid hygiene could help minimize the symptoms of blepharitis or keep those symptoms from returning.
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