Blepharitis - About the Disorder

by Dr. Daniel Zimmer

Posted on Wednesday 10th of December 2008

Blepharitis is an inflammation of the eyelid margin. This is a chronic inflammation of the eyelids that causes excessive growth of bacteria that is normally present on the skin. Blepharitis can be associated with seborrheic dermatitis or a bacterial infection, sometimes a combination of both.

Blepharitis is a disorder of the oil glands of the eyelids. The oil actually coats the lid and lash margins forming, what Doctors call a sticky dandruff. This material can fall into the eyes causing: redness, burning, tearing, itching, the lids to stick together, and a feeling like something is in the eye. A patient may have some or all of these symptoms.

An examination of the eyelids during an eye exam is usually enough to properly diagnose blepharitis.

Blepharitis can present with many symptoms and is often misdiagnosed. Patients with puffy, red eyelids may be told they have allergic, viral, or bacterial conjunctivitis.

Blepharitis usually presents with crusty, itchy, red, and possibly swollen eyes. It is usually worse in the morning with the lids actually stuck together. This is in contrast to dry eyes where the symptoms worsen towards evening.

Blepharitis is divided into posterior and anterior forms. Posterior is often associated with sties or chalazia and possibly lash loss. Anterior blepharitis presents with scaly lid dandruff.

The primary treatment of this disorder is careful cleansing of the lid margins to remove the skin oils that the bacteria feed on. Treatment is helpful in controlling bacteria on the lids and can include: lid scrubs with baby shampoo or commercial preparations, warm compresses, topical and/or oral antibiotics, steroids, and nutritional supplements.

When performing a warm soak of the eyelids, the first step is to wash your hands with soap and water. Step two is to moisten a clean washcloth with warm water and the final step is to close your eyes and place a warm washcloth on the eyelids for approximately five minutes. Repeat this several times daily.

When performing an eyelid scrub, the first step is to wash your hands with soap and water. Run some warm water into your clean hands and mix a tiny bit of baby shampoo with the warm water and a clean washcloth. Close your eyes and scrub your eyelids and lashes. Rinse with clear, warm water.

If you have blepharitis, you may experience loss of eyelashes, abnormal eyelash growth (misdirected eyelashes) or scarring of the eyelids. Other possible complications associated with blepharitis include:

- Sty. A sty is a bacterial infection that develops near the root of an eyelash. The result is a painful lump on the edge or inside of your eyelid. A sty is usually most visible on the surface of the eyelid.

- Chalazion. A chalazion occurs when there's a blockage in one of the small oil glands at the margin of the eyelid. The gland can become infected with bacteria, which causes a red, swollen eyelid. Unlike a sty, a chalazion is most prominent on the inside of the eyelid.

- Excess tearing or dry eyes. Abnormal oily secretions and other debris shed from the eyelid, such as flaking associated with dandruff, can accumulate in your tear film — the water, oil and mucus solution that form tears. An abnormal tear film interferes with the healthy lubrication of your eyes. There may be enough irritation to stimulate excessive tearing. Inflammation associated with blepharitis can interfere with the function of some of the non-oil-producing glands in the eyelid and lead to dry eyes.

- Chronic pink eye. Blepharitis can lead to recurrent bouts of pink eye (conjunctivitis).

- Injury to the cornea. Constant irritation from inflamed eyelids or misdirected eyelashes may cause a sore (ulcer) to develop on your cornea. Insufficient tearing could predispose you to a corneal infection.
It is important to understand that if you stop doing your lid hygiene, the blepharitis will come back. It is a normal body function. This can only be controlled, not cured.