Understanding Blepharitis

Blepharitis is a general term for eyelid inflammation, usually involving the lid margin and eyelashes, including both infectious and non-infectious forms. The cause is often staphylococcal infection.

Poor hygiene may be a contributing factor. Often seborrheic problems such as dandruff are also present. Excess secretion by the meibomian glands is the most common form called seborrheic blepharitis.

Oily deposits form as crusty collections on the lid margin and provide the eyelid bacteria with an ideal environment for growth, so staphylococcal infection often accompanies and exacerbates seborrheic blepharitis.

There is a strong association between all forms of blepharitis and dry eye. Tear deficiency may promote meibomian gland dysfunction.

What are the symptoms?

Blepharitis is typically bilateral. Symptoms vary but may include:

• Itching
  
• Burning
  
• Scratchiness
  
• Foreign body sensation
  
• Excessive tearing
  
• Filmy vision
  
• Crusty debris around the eyelashes – especially upon waking

Recommended Treatment Plan

Treatment of blepharitis usually involves 3 steps:

1. Hot compresses
   
2. Lid massage
   
3. Lid cleaning

1. Hot Compress

• Heat face towel with hot tap water – as warm as tolerated but don’t burn eye
  
• Place on closed eyelids for 5 minutes

2. Lid Massage

• Use fingers or cotton bud to massage oil from glands
  
• Stroke downwards towards the lashes for the top lid
  
• Stroke upwards towards the lashes for the lower lid
  
• Massage for 3 minutes

3. Lid Cleaning

• Use Sterilid® as directed morning and night
  • Initially perform twice a day, morning and night.
    
  • For the first 2 weeks it may get slightly worse due to accumulated oils coming out
    
  • After 2 – 3 weeks of cleaning, if symptoms are settling, this routine can be performed once a day (eg. in the shower)
    
  • Lubricants in addition can also relieve symptoms

This treatment alone may control symptoms. It dissolves eyelash and skin debris that is often laden with bacteria.

For severe or chronic cases of staphylococcal blepharitis, topical antibiotic ointment or drops should be used for seven to ten days.

Ointment applied directly to the lid margins twice daily after lid hygiene is the best option.

If there is excessive lid inflammation and/or discomfort a cortisone eye ointment may be helpful.

Disclaimer

The information provided here is for general education only and should not be construed as individual medical advice. For advice relevant to your particular situation, please speak to Dr Hornsby.