Blepharitis is a very common condition. It can affect all ages but is more prevalent in the over 50 age group. It is a chronic (long term) condition and affects the lid margins. If it affects the front of the lid margin near or around your eyelashes we refer to it as anterior blepharitis, and if it affects the glands towards the back of the lid margin we call it posterior blepharitis. It is possible to have one or the other, or a combination of both at the same time. Over time this can cause inflammation to the lids and the surface of the eye and leads to discomfort.
Anterior blepharitis can be caused by a skin condition known as seborrhoeic dermatitis or by a bacterial infection (usually staphylococcal), or by a little mite called Demodex.
Posterior blepharitis is caused by blockages in the meibomian glands that sit on the margin of the upper and lower lids behind your lashes. We refer to this as Meibomian Gland Dysfunction or MGD for short. These glands are important as they provide the outer oily layer of the tear film. Without this layer the tear film to becomes unstable and evaporates. This causes dry areas to form on the surface of the eye. Also seborrheic dermatitis can cause posterior blepharitis.
The symptoms of blepharitis can vary from sore eyelids, gritty eyes, itchy eyes, crusting at the base of the lashes, red and thickened eyelids, dry eyes, and blurred vision. In fact blepharitis is one of the commonest reasons why people have dry eyes.
Long term blepharitis can lead to loss or misdirection of lashes, notches forming in the lid margin, chronic dry eye, and susceptibility to meibomian cysts.
When we examine your eyes we can determine the type of blepharitis you have using a high powered microscope called a slit lamp. We can then advise a treatment plan tailored to your own needs. Lid hygiene is one of the main lines of treatment in the management of blepharitis, which involves cleaning of the lids with recommended products such as Blephasol. It is often combined with warm compresses using an eye bag to soften and alleviate any crusts on the base of the lashes. Warm compresses also help to alleviate Meibomian Gland Dysfunction as it softens secretions in the blocked glands prior to lid massage, therefore improving the outer oily tear layer. If we suspect you may have Demodex blepharitis a different treatment regime may be advised. Alongside these treatment plans we may also advise artificial tears, and for long term use would advise preservative free products. We have a number of products available at the practice which we can recommend.
Very rarely in more severe forms of blepharitis antibiotics may be required.
Blepharitis is chronic long term condition but can be managed well with the above treatments.