Blepharitis - Chronic Inflammation of the Eyelids

Blepharitis is a chronic inflammation of the eyelids. A common problem in both children and adults, itching and irritation of the eyelids. There are two types of blepharitis: seborrheic and Staphylococcus (staph).

The eyelid

The outer layer of the eyelid is composed of skin, while the inside of the eyelid is lined with moist tissue. Muscles and glands are located between the skin and the moist lining. The eyelashes are located on the eyelid margins, the areas which come together when the eyelid is closed. Tiny openings, from which glands secret the oily part of tears, are also located on the eyelid margin. The eyelid margins are the areas most often affected by blepharitis.

What is seborrheic blepharitis?

Seborrheic blepharitis is associated with dandruff of the scalp and may be part of an overall skin disease (seborrhea) which also affects the chest, back and behind the ears. With seborrheic blepharitis, the glands of the eyelid produce an abnormal quantity and quality of tear film, which normally coats, protects, and lubricates the eye. Several factors including hormones, nutrition, general physical condition, and stress may contribute to the development of this condition.

What are the symptoms of seborrheic blepharitis?

This form of blepharitis is characterized by redness of the eyelids. Scaling and flaking around the eyelashes are also common. The production of abnormal tear film causes the formation of greasy, waxy scales. These scales, which accumulate at the base of the eyelashes, flake off easily.

What is staph blepharitis?

Staph blepharitis is a more severe condition which often begins in childhood and continues through adulthood.  Infective in nature, staph blepharitis is caused by bacteria (Staphylococcus aureus).

What are the symptoms of staph blepharitis?

Staph blepharitis is characterized by matted, hard crusts around the eyelashes. The crusts may make opening the eyes in the morning difficult.  Removal of the crusts often leaves small ulcers which bleed or ooze.

In some cases of staph blepharitis, a red eye may develop or a sty may form.  A loss of lashes or broken lashes may be experimenced. If left untreated, staph blepharitis may lead to infection and scarring of the cornea and other areas of the eye.

How is blepharitis treated?

It is often difficult to distinguish between the two types of blepharitis, as they frequently appear together. The main difference is the presence of ulcers with staph blepharitis.  These ulcers are not present with seborrheic blepharitis.  However, both forms of the disease are treated similarly.

Treatment of blepharitis is concentrated on maintaining very clean eyelid margins.  The eyelids must be kept immaculately clean. Scrubbing with  a solution of water and mild baby shampoo (20 drops of water to one drop of baby shampoo) is usually recommended for cleaning.

In severe cases, antibiotic drops and ointments are also helpful in controlling the condition. Cortisone drops or preparations often relieve the bothersome symptoms of itching and irritation.  However, prolonged use of cortisone may cause undesirable side effects.

Application of hot packs may provide additional relief. The heat causes the blood vessels to dilate, which improves blood circulation and healing. The heat also opens and cleans outinfected gland pores in the eyelid margin.  In cases of seborrheic blepharitis, treatment of the scalp with anti-dandruff shampoos may also be helpful.

Once the acute phase of blepharitis is controlled, lid clenaing and the use of bland ointments may be sufficient to control the condition. Blepharitis can be a continuing problem which is difficult to eliminate completely. However, with vigorous treament and patient cooperation, blepharitis can almost always be controlled.

Prevention is the best medicine

Regular eye examinations are the best prevention against eye diseases. Eye problems can occur at any age, and the symptoms of some problems are not noticeable until the eye has suffered damage.  However, with early detection and treatment of eye problems, sight loss can often be prevented.

If you are experiencing the symptoms of blepharitis or other vision problems, you should obtain a complete eye examination.