Blepharitis is inflammation of the eyelids. It may be an anterior, posterior or combined blepharitis.
It is important not to confuse blepharitis with a locally invasive skin cancer as seen in this photo.
Anterior blepharitis is localised to the base of the eyelashes. It is caused by a low-grade infection by the commensals that naturally live on our eyelids. One can see flaky white debris on the base of the eyelashes. Anterior blepharitis causes itchy eyes, with a foreign body sensation and grittiness along with redness. Sometimes patients can develop styes on the eyelids or infections of the cornea (marginal keratitis) due to anterior blepharitis.
Posterior blepharitis is a condition that involves the eyelid margin (water line) and the meibomian glands of the eyelids. Meibomian glands are glands that produce an oily substance that covers the aqueous part of the tearfilm which in turn, prevents the tears from drying out. These glands are present in the firm cartilage like part of the eyelids and open onto the eyelid margin. There are about 40-50 glands in our upper eyelids and about 20 in the lower eyelids. If the quality of the oily substance produced by the glands is not of a good quality the oil cannot flow out of the glands and hence the eyes get dry and irritable. Sometimes the opening of the glands onto the eyelid margin are blocked by plugs, not allowing the oily substance to flow onto the surface of the eye resulting in meibomian cysts called Chalazia.
Symptoms of blepharitis range from itchy eyelids to irritable, gritty eyelids that are dry. Some patients may experience photophobia and some may feel that their eyes are heavy and feel tired, making the patients feel sleepy towards the end of the day and some may experience a thick mucoid discharge from their eyes especially in the morning.
Treatment of blepharitis requires a long-term commitment.
Conservative measures like lid hygiene and warm compresses along with flax seed oil taken orally can help to keep on top of the inflammation. Sometimes certain antibiotics may be needed orally or applied locally along with steroids onto the eyelids.
Warm compress:
Either by running a face cloth under warm tap water or by obtaining an eye mask that can be warmed in the microwave from a pharmacy. Electronic warming devices are also available on the market. Place the warm face cloth / eye mask onto your eyes for 4-5 minutes. Follow this with lid hygiene as below. Do this twice a day on a long-term basis.
Lid hygiene:
Boil water in a kettle, let it cool down till it gets lukewarm. Take a cup of this warm water and add a capful of baby shampoo to it. Dip a cotton bud into the solution and rub it onto the base(roots) of your eyelashes and the eyelid margin (water line) to get rid of the debris and also to scuff off the plugs from the meibomian gland opening on the eyelid margin. You can also buy eyelid cleansing products from your optician or pharmacy, eg Blephasol or related products to clean your eyelid margin. Do this twice a day.
Eyelid massage:
Once the oil in the glands has been encouraged to liquefy with the warmth and the opening of the glands are cleared, carefully massage your eyelids with your finger or a cotton bud.
https://www.bopss.co.uk/public-information/common-conditions/blepharitis/
It’s natural to feel anxious when it comes to treatment and surgical procedures especially in relation to your eyes. I encourage you to ask questions about your condition, so I can help you to be better informed of your condition, the treatment options available and allay any fears that you may have. During the consultation I will explain the procedures to you and help you to make positive choices, and remember there is always the option of doing nothing, so you have nothing to worry about.
