Blepharitis

Blepharitis is an inflammation of the eyelids and eyelashes causing red, irritated, itchy eyelids and the formation of dandruff-like scales on eyelashes. It is a common eye disorder generally caused by either a bacterial infection or a general skin condition such as dandruff of the scalp or acne rosacea. It affects people of all ages. Although uncomfortable, blepharitis is not contagious and does not cause any permanent damage to eyesight.

Blepharitis is classified into two types:

1. Anterior blepharitis occurs at the outside front edge of the eyelid where the eyelashes are attached.
2. Posterior blepharitis affects the inner surface of the eyelid that comes in contact with the eyeball.

Individuals with blepharitis may experience a gritty or burning sensation in their eyes, excessive tearing, itching, red and swollen eyelids, dry eyes, or crusting of the eyelids. For some people, blepharitis causes only minor irritation and itching. However, it can lead to more severe symptoms such as blurring of vision, missing or misdirected eyelashes, and inflammation of other eye tissue, particularly the cornea.

In many cases, good eyelid hygiene and a regular cleaning routine can control blepharitis. This includes frequent scalp and face washing, using warm compresses to soak the eyelids, and doing eyelid scrubs. In cases where a bacterial infection is the cause, various antibiotics and other medications may be prescribed along with eyelid hygiene.

What causes blepharitis?

Blepharitis can appear as greasy flakes or scales around the base of the eyelashes.

Anterior blepharitis is commonly caused by bacteria (staphyloccus blepharits) or dandruff of the scalp and eyebrows (seborrheic blepharitis). It may also occur due to a combination of factors, or less commonly may be the result of allergies or an infestation of lice on the eyelashes.

Posterior blepharitis can be caused by excessive oil production by the glands of the eyelids (meibomian blepharitis) which creates a favorable environment for bacterial growth. It can also develop as a result of other skin conditions such as acne rosacea and scalp dandruff.

How is blepharitis treated?

Treatment depends on the specific type of blepharitis. The key to treating most types of blepharitis is keeping the lids clean and free of crusts.

• Warm compresses can be applied to loosen the crusts, followed by gentle scrubbing of the eyes with a mixture of water and baby shampoo or an over-the-counter lid cleansing product. In cases due to bacterial infection, an antibiotic may be prescribed, along with lid hygiene.
• If the glands in the eyelids are blocked, the eyelids may need to be massaged to clean out oil accumulated in the eyelid glands.
• If the blepharitis makes the eyes dry, artificial tear solutions or lubricating ointments may be prescribed.
• If lice are the cause, petroleum jelly can be applied along the base of the eyelashes to eliminate them.

Use of an anti-dandruff shampoo on the scalp can help. In addition, limiting or stopping the use of eye makeup is often recommended, as its use will make lid hygiene more difficult. If you wear contact lenses, you may have to temporarily discontinue wearing them during treatment.

Blepharitis seldom disappears completely. Even with successful treatment, relapses may occur.

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