Blepharitis – Eyelid Margin Disease

Eyelid Margin Disease including Blepharitis or Meibomian Gland Dysfunction

Eyelid margin disease is a common and persistent inflammation of the eyelids. Symptoms include:

  • eye & eyelid irritation;
  • itchiness of the eye;
  • redness of the eye.

One of the most common eye conditions that I see in my practice is blepharitis – inflammation along the eyelid margin.  Patients with blepharitis complain of burning irritation in both eyes, often with crusty mattering that sticks to the eyelids in the morning.  Redness in the eye and on the eyelids and a gritty sensation are often present.

What causes blepharitis?

The causes of blepharitis are multiple but the main culprit is excess oil production by the glands along the eyelid margin that can lead to bacteria overgrowth which in turn can produce toxins to further irritate the eyes.

Everyone has bacteria on the surface of their skin, but in some people, bacteria thrive in the skin at the base of the eyelashes. Large amounts of bacteria around the eyelashes can cause dandruff-like scales and particles to form along the lashes and eyelid margins.

This condition frequently occurs in people who have a tendency towards oily skin, dandruff or dry eyes.

Blepharitis also is associated with meibomitis-dysfunction and inflammation of the nearby oil glands of the eyelids (called meibomian glands).

How is it treated?

While medications such as erythromycin ointment, azithromycin eye drops, and in severe cases, topical steroids and oral tetracyclines can be very helpful, the most important aspect in the management of blepharitis is daily lid hygiene – cleaning the eyelids with a hot wash cloth with or without a dab of baby shampoo.  A process that takes 20 seconds or less but very few patients do it consistently once the acute phase of the disease is over.

So remember:

Blepharitis is often a chronic condition, but it can be controlled with the following treatments:

Warm compresses. Wet a clean washcloth with warm water, wring it out, and place it over your closed eyelids for at least one minute. Repeat two or three times, rewetting the washcloth as it cools. This will loosend scales and debris around your eyelashes. It also helps dilute oil secretions from nearby oil glands, preventing the development of a chalazion (pronounced kuh-lay-zee-un) – an enlarged lump caused by clogged oil secretions in the eyelid.

Eyelid scrubs. Using a clean washcloth, cotton swab or commercial lint-free pad soaked in warm water, gently scrub the base of your eyelashes for about 15 second per eyelid.

Antibiotic ointment. We may prescribe an antibiotic ointment. Using a clean fingertip or cotton swab, gently apply a small amount at the base of the eyelashes before bedtime.

Artificial tears or steroid eye drops may also be prescribed temporarily to relieve dry eye or inflammation.

Good hygiene. Because blepharitis can be a persistent problem, you should practice good skin and eyelid hygiene to prevent recurrences. In addition to careful cleaning of your eyelashes, washing your hair, scalp and eyebrows with antibacterial shampoo can also help control blepharitis.