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Blepharitis

Blepharitis is inflammation of the eyelids. It occurs at any age and is sometimes linked to certain diseases.  Cleaning of the eyelids and antibiotics give some relief. Blepharitis can be a recurrent or chronic condition for many.

Long description

With blepharon being the Greek name for eyelid and “itis” meaning inflammation, it is plain to see how inflammation of the eyelids got its name. Blepharitis is a common condition which is sometimes confused with conjunctivitis. Both can cause stickiness of the eyes and in both the eyes appear red and inflamed. However, on closing inspection, the redness is of the eyes in conjunctivitis is actually on the tissue at the margins of the eyes. The inflammation of the eyes in blepharitis appears mainly in the eyelids. Blepharoconjunctivitis may occur where there is inflammation of both the eyelids and the conjunctivae. It is important to distinguish between blepharitis and conjunctivitis because there are differences in treatment.

 

Causes

There are various causes of blepharitis. One of the main ones is underlying skin disease. Seborrhoeic dermatitis is an example. It causes scaly redness of the skin and a scaly rash of the scalp. Another skin condition associated with blepharitis is acne rosacea. This condition if more common in women and causes a butterfly shaped redness of the cheeks and nose. The eyelids may also be inflamed.  Inflammation of the tiny glands found in the eyelids also causes blepharitis. A condition causing dryness of the eyes (keratoconjunctivitis sicca) is also linked with blepharitis.

 

Allergic reactions involving the eyelids may also cause blepharitis. There could be an allergic reaction to mascara or eyeliner for example. Blepharitis can also be part of a larger allergic reaction. This can occur in hay fever or the more serious allergic reaction of angioedema where there the eyelids may be very swollen. Blepharitis can also occur in infection. This infection may be confined to just the eyelids as with a bacterial or viral infection. When infection is the culprit, conjunctivitis may also be present.

 

Symptoms

Blepharitis in itself causes redness of the eyelids – a bit like looking at red-rimmed eyes. The eyelids may be sticky, watery and swollen. The eyes may feel gritty and dry. If blepharitis is linked to seborrhoeic dermatitis, there may be yellowish crusts on the eyelids. Babies thought to have never-ending conjunctivitis with sticky yellow discharge, may have blepharitis due to seborrhoeic dermatitis. There may be itchiness of the eyelids, particularly if there is an underlying allergy. If blepharitis is due to acne rosacea, the sufferer will have the telltale butterfly-pattern red rash on the face and possibly the nose. Troublesome dandruff and blepharitis is likely to be due seborrhoeic dermatitis. Blepharitis tends to occur in older people in their 40’s and upwards.

 

Treatment

Simple, regular bathing of the eyelids to remove crusts and debris is important, especially if blepharitis persists. If seborrhoeic dermatitis is the underlying cause, antifungal shampoo such as ketoconazole to treat the scalp is helpful. This can be purchased over the counter. Steroid cream helps to control the skin inflammation.

If allergy is the problem, antihistamine tablets and antihistamine eye drops target the inflammatory reaction which the histamine released in the body produces. Avoiding the substance causing the reaction is crucial.  Bacterial infection requires antibiotics and these are available in the form of eye drops or eye ointment. Artificial tears help if the eyes are dry. The blepharitis of acne rosacea is managed by treating the rash.

When blepharitis is severe and persistent despite good eyelid hygiene and antibiotic applied to the eye, the doctor may try a course of antibiotics by mouth.

 

Prevention

Blepharitis is not easy to prevent however it can be helped by avoiding any factors which provoke it. This will mean avoiding any offending eye make-up, having good control of acne rosacea and seborrhoeic dermatitis, using antifungal shampoo periodically to prevent blepharitis and thorough eyelid hygiene.

Blepharitis is often confused with conjunctivitis but they are separate conditions. As it accounts for 1 in 20 of the eye conditions which a GP sees, it probably sits at 3 in a 1 to 5 scale. However rather than visit the GP, many may choose to suffer in silence, so it could be more common than believed.

In: General Medicine,