Blepharitis Patient Information

Blepharitis, a chronic inflammation of the eye lid margin, is one of the commonest eye disorders. It causes a variety of eye symptoms including eye discomfort, redness, tearing, foreign body sensation and light sensitivity. It can affect people of all ages but is more common among the older age group. Blepharitis related dry eyes is a common finding in an average ophthalmological practice and is often inadequately treated.

There are 3 forms of blepharitis:

1. Staphylococcal blepharitis– This form is caused by a type of bacteria commonly found on skin over the eye lid called staphylococcus aureus. Typically there is crusting and scaling along the eye lashes with associated inflammation of the lid margin,

2. Seborrheic blepharitis– Patients affected by this form of blepharitis have greasy crusting and scaling along the eye lashes. Often, they also suffer a skin condition called seborrheic dermatitis.

3. Meibomian gland dysfunction (MGD)– Meibomian glands are oil secreting glands found along the lid margin. The oil secreted is essential for normal formation of tear film. In MGD, the glands are blocked by abnormal thick, foamy and turbid oil secretions resulting in poor tear film.

Since blepharitis causes a chronic inflammation of the eye lid margin, it affects the general health of the glands of the eye. This compromises the quality of the tear film resulting in dry eye symptoms. The toxins produced by the bacterial infestation cause inflammation which untreated can result in painful corneal ulcers. Additionally, patients with chronic blepharitis is at a higher risk of developing styes (infected meibomian glands), chronic dry eyes and in severe cases cornea damage which may result in poor vision.

Blepharitis Treatment

Since blepharitis is a chronic disease, there is no permanent cure. It often requires long-term treatment to keep it under control. Treatment options consist of the following;

1. Warm compresses and lid scrubs– This treatment involves gently warming the eye lids with the help of a hot towel. This action softens the oily debris and crust on the lid margin so that they can be easily removed with the lid scrubs. Lid scrubbing can be performed by using diluted mild non-irritant soaps on a cotton bud. Alternatively, one can use commercially available cleansing pads suitable for eye use.

2. Artificial tears and ocular lubricants– Artificial tear and ocular lubricants are used to treat ocular discomfort and dryness. They act by diluting and washing away toxins and irritants from the eye surface. Many types of are commercially available.

3. Antibiotics– Occasionally, antibiotics are required to reduce the bacterial load on the eye lids. This treatment can be in the form of eye ointment or oral medication. In addition to the anti bacterial properties, some oral antibiotics such as doxycycline and tetracycline have properties that improve meibomian gland secretions thereby improving tear quality.

4. Anti inflammatory drops– Anti inflammatory treatment such as steroid and cyclosporine eye drops are sometimes required to treat the inflammation associated with blepharitis and dry eyes. Although steroid eye drop is highly effective, caution is needed as prolonged use can result in serious eye conditions such as cataract and glaucoma. In additional to its anti inflammatory properties, cyclosporine eye drop has been shown to increase natural tear production.

Diet– Food rich in Omega-3 fatty acids, flaxseed oil and castor oil have been shown to reduce inflammation associated with blepharitis. Anti-oxidants are also thought to be useful in the treatment of blepharitis.