What is Blepharitis?

Blepharitis is an inflammation of the eyelids in which they become red, irritated and itchy with dandruff-like scales that form on the eyelashes. It is a common eye disorder caused by either bacteria or a skin condition, such as dandruff of the scalp or rosacea.

What are the types of Blepharitis?

There are 2 types of blepharitis. You may have a single type of blepharitis, or you may have both types at the same time.

Anterior Blepharitis

Anterior blepharitis affects the outside of your eye, where your eyelashes attach to your eyelid. It usually happens because of bacteria on your skin or dandruff from your scalp or eyebrows. Allergies or mites (tiny parasites) may also cause anterior blepharitis, but this is rare.

Posterior Blepharitis

Posterior blepharitis affects the outside of the inner edge of the eyelid — the part that touches your eye. This type of blepharitis happens when the oil glands in your eyelids get clogged. Common skin conditions like rosacea and scalp dandruff can cause posterior blepharitis.

How to Recognize Blepharitis?

Blepharitis symptoms are often mild and never life-threatening. As the name suggests, the condition involves inflammation of the eyelid. Dry eyes almost always accompany blepharitis. Many physicians consider the two symptoms to be part of the same condition, which is sometimes referred to as DEBS (dry eye blepharitis syndrome). Other symptoms include:

  • Crust on eyelashes
  • Blurred vision
  • Itching and burning of the eyes
  • Red, swollen, puffy appearance
  • Blinking to remove debris from eyes

Blepharitis can also cause more serious problems like:

  • Blurry vision
  • Eyelashes that fall out
  • Eyelashes that grow in the wrong direction
  • Swelling of other parts of the eye, like the cornea

Blepharitis

Common Causes of Blepharitis

  • Anterior blepharitis is commonly caused by bacteria (staphylococcal blepharitis) or dandruff of the scalp and eyebrows (seborrheic blepharitis). These bacteria are commonly found on the face and lids, but if they become excessive, or the lid area reacts poorly to their presence, an infection may occur. Less commonly, allergies or a mite infestation of the eyelashes can cause anterior blepharitis.
  • Posterior blepharitis can occur when the glands of the eyelids irregularly produce oil (meibomian blepharitis). This creates a favorable environment for bacterial growth. Posterior blepharitis can also develop as a result of other skin conditions, such as rosacea and scalp dandruff.

When to See a Doctor for Blepharitis

Blepharitis can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on the eyelids and the front surface of the eyeball, may include:

  • Patient history to determine any symptoms the patient is experiencing and any general health problems that may be contributing to the eye problem.
  • External examination of the eye, including lid structure, skin texture, and eyelash appearance.
  • Evaluation of the lid margins, the base of the eyelashes and meibomian gland openings using bright light and magnification.
  • Evaluation of the quantity and quality of tears to check for any abnormalities.

A doctor of optometry can determine the type of blepharitis based on the appearance of the eyelid margins. The different types and symptoms are as follows:

  • Staphylococcal blepharitis patients frequently exhibit mildly sticking eyelids, thickened lid margins, and missing and misdirected eyelashes.
  • Seborrheic blepharitis patients have greasy flakes or scales around the base of eyelashes and a mild redness of the eyelids.
  • Ulcerative blepharitis patients have matted, hard crusts around the eyelashes. Removing the crusts leaves small sores that ooze and bleed. These patients may also experience eyelash loss, distortion of the front edges of the eyelids and chronic tearing. In severe cases, the cornea (the transparent front covering of the eyeball) becomes inflamed.
  • Meibomian blepharitis patients have a blockage of the oil glands in the eyelids, poor quality of tears and redness of the lining of the eyelids.

Blepharitis Treatment

The best way to treat blepharitis is to keep your eyelids clean and free of crusts. Use water and a gentle cleanser (like baby shampoo) to clean your eyelids and remove crusts every day.

Steps for cleaning your eyelids when you have blepharitis:

  1. Wash your hands with soap and water.
  2. Mix warm water with a gentle cleanser, like baby shampoo.
  3. Dip a clean, soft cloth or cotton swab in the warm cleanser and water mixture.
  4. Press the cloth against your closed eye for a few minutes to loosen crusts. This can also help keep your oil glands from clogging.
  5. Gently rub the cloth or cotton swab back and forth, focusing on the area where your eyelashes meet your eyelids.
  6. Rinse your eye with clean water.
  7. Repeat these steps on your other eye using a new cloth or cotton swab.

There are other treatment options that may help you manage blepharitis. Ask your eye doctor if any of these options are right for you:

  • Eye drops. Your doctor may prescribe steroid eye drops to control redness, swelling, and irritation. Your doctor may also recommend a type of eye drops called artificial tears. You can get these eye drops without a prescription.
  • Medicines that fight infection. If your blepharitis is caused by bacteria, your doctor may prescribe antibiotic eye drops, ointments, or pills.
  • Treating other health problems. If another health problem like rosacea or dandruff is causing your blepharitis, treating that condition will help.

Blepharitis usually doesn’t go away completely. You’ll need to follow a routine for cleaning your eyelids for the rest of your life to keep it under control.

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