Blepharitis

Blepharitis is a very common problem that causes dry eyes, redness, itching, watering, crusting of eyelashes, and irritation of the eyes.  It is not known why some people develop this disorder, but it tends to be common in young children and in middle aged to older adults.  While there is no ‘cure’ for blepharitis, there are many things that can be done to improve it.

Blepharitis is a disorder of the oil glands within the eyelids, called meibomian glands. These numerous oil glands are in the edge of the eyelids, next to the eyelashes. They secrete oil onto the surface of the eye, which serves an important role in a healthy tear film. This oil stabilized the tear film and keeps it from evaporating.

With blepharitis, these oil glands have a tendency to get clogged up and inflamed. The oil becomes less liquid, and cannot express out of the gland as it should. This leaves the surface of the eye inflamed, irritated, and red.

Patients may have burning and the feeling of something in the eye like an eyelash. This symptom may be worse after reading or using the computer. The eye reflexively responds to this inflammation with extra tear production, and makes the eyes watery. This along with the poor tear film can cause intermittently blurred vision.

In more severe cases the plugged up oil glands become red and swollen, forming a red bump on the eyelid.  Commonly called a stye, if this does not improve, it can turn into a long lasting lump called a chalazion.

Finally this unhealthy environment allows an overgrowth of the normal bacteria on the surface of the eye, especially staphylococcal bacteria.  This creates inflammation and can commonly cause crusty deposits to build up on the eyelashes as well as waking up with the eyelids glued shut.  These bacteria can also damage the cornea causing an ulcer which can be very painful and even vision threatening.

There are a variety of treatments for blepharitis.  The most important is daily warm compresses for the eyes.  A warm, moist washcloth held over the eyes for five minutes in the morning helps liquefy the dried oil and keeps them flowing better.  This regimen takes a little bit of time, but if done routinely, should improve symptoms within several weeks.  It is important to continue this hygiene, because the problem will likely recur once the compresses are stopped.  If lid crusting is a problem, gentle scrubbing of the lid margins is helpful.

Sometimes prescription medications are helpful, including topical antibiotic ointments, antibiotic drops, and even oral antibiotics, particularly if the problem is associated with rosacea, a dermatologic problem.  Topical steroids can be helpful in short courses, but have potentially serious side effects such as cataracts and glaucoma if over used.  Finally many patients find that dietary supplements such as flax seed oil or fish oils with omega-3 fatty acids can help.  These are taken orally and are available in most pharmacies.

While blepharitis is a chronic condition, there are many treatments available.  It is important to keep those oil glands healthy so that they can protect your eyes for your lifetime.