Definition
Blepharitis is an inflammatory condition of the eyelids.
Incidence/age
Blepharitis can occur at any age. It is a very common eye disorder which may go unnoticed at a younger age.
Causes
The exact cause of blepharitis is unknown. The mechanism of blepharitis is that oils and other products normally secreted by the eye and the skin build up on the lid surface and the eye lashes causing debris. This results in symptoms of eye irritation. In some cases bacterial infection develops in the debris exacerbating the condition.
Signs/symptoms
Blepharitis usually affects both eyes. It may result in a burning or foreign body sensation of the eyes, redness of the eyelid margins and the eye itself, and crusting at the base of the eyelashes. In some cases, complicated by infection, minute ulcers form at the lid margin, adjacent to the base of the eyelashes.
The symptoms of discomfort are frequently worse in the mornings and the condition is characterised by spontaneous improvement and exacerbation of the symptoms. Associated features may include loss of some eyelashes and misdirection of others with inturning of the eyelashes towards the eye.
Complications of disorder
Meibomian glands are contained within the eyelids and open on the margin of the lid where it touches the eye. The Meibomian glands produce the oily secretions which help to lubricate the surface of the eye. Blepharitis can lead to blockage of the openings of the Meibomian glands. In turn this can lead to symptoms of dry eyes.
Blockage of the Meibomian gland opening may also lead to secretions accumulating within the gland, which then swells to form a Meibomian cyst within the eyelid. Other complications of blepharitis may include recurrent episodes of conjunctivitis, sterile ulcers at the edge of the cornea (the clear window at the front of the eye) and distortion and notching of the eyelid margin in severe cases.
Tests
Blepharitis is a condition which is diagnosed by clinical examination by the Ophthalmologist (eye doctor). Laboratory investigations can include bacterial cultures of swabs taken from the eyelid margin.
Treatment
- The main therapy is careful cleaning of the eyelids and lashes to remove the irritating substances that have accumulated:
- Warm compresses - soak a clean face cloth in warm water and apply to the closed lids for 5-10 minute period rewarming the cloth repeatedly.
- Lid cleaning - following the warm compress clean the eyelid margins with a clean moistened cotton wool bud using a side to side motion to remove the debris from the eye lids and the eye lashes. The cotton wood bud is moistened with a solution of bicarbonate of soda. This is made by taking 1 pint of boiled water, letting it cool and adding a teaspoon of bicarbonate of soda. A small amount of the solution is used to moisten the cotton wood bud each time the lid hygiene is carried out. Lid hygiene is usually carried out twice a day initially, reducing to once a day as the symptoms improve.
Additional treatments which may be recommended on a short term basis include antibiotic ointment. A small amount of ointment is placed on the fingertips and rubbed on to the lid margins and the eyelashes following the lid hygiene for a period of two weeks.
A course of oral antibiotics may be recommended for severe or persistent cases of blepharitis.
Surgical treatment is not required for the treatment of blepharitis.
Outcome
In the majority of cases, the symptoms of blepharitis improve within 2-8 weeks of starting treatment. Blepharitis is a condition which is present throughout life. The treatment of blepharitis is aimed at minimising symptoms and making the eyes more comfortable
Source: www.privatehealth.co.uk
Last Editorial Review: 18/1/2010
