What is blepharitis?
Blepharitis is a condition characterized by inflammation of the eyelids. There are two forms: anterior blepharitis, which affects the outside front of the eyelid where the eyelashes are attached, and posterior blepharitis, which affects the inner eyelid, the moist part that makes contact with the eye.
What causes blepharitis?
The two most common causes of anterior blepharitis are bacteria (staphylococcus) and scalp dandruff (seborrheic dermatitis). Posterior blepharitis is caused by problems with the oil (meibomian) glands in this part of the eyelid. Two skin disorders can occur along with this form of blepharitis: acne rosacea, which leads to red and inflamed skin of the face, and scalp dandruff.
Symptoms of either form of blepharitis include:
- crusting of the eyelashes especially on awakening;
- dry eye symptoms such as burning or feeling like there is "sand" in the eyes;
- redness and swelling along the edges of the eyelids;
- excessive tearing;
- sensitivity to light (photophobia);
- redness inside the eye;
- blurred vision;
- frothy tears;
What other conditions are associated with blepharitis?
Complications from blepharitis include:
- A red tender bump on the eyelid that is caused by an acute infection of the oil glands of the eyelid.
- Chalazion: This often painless, firm lump can follow the development of a stye, and is caused by inflammation of the oil glands of the eyelid. If there is an infection, chalazion can be painful and red.
- Problems with the tear film: Abnormal or decreased oil secretions that are part of the tear film can result in excess tearing or dry eye. Because tears are necessary to keep the cornea healthy, tear film problems can place people at higher risk for corneal infections.
Since blepharitis is a chronic condition, managing the disease is key. Most people with blepharitis maintain an eyelid hygiene routine for life. Treatment for both forms of blepharitis involves keeping the lids clean and free of crusts. Warm compresses should be applied to the lid to loosen the crusts, followed by a light scrubbing of the eyelid with a cotton swab and a mixture of water and baby shampoo. In addition, people with posterior blepharitis will need to massage their eyelids to clean the oil accumulated in the glands. If the blepharitis is severe, an eye care professional may also prescribe antibiotic ointment or steroid eyedrops. In some cases, antibiotic pills may be required for several months at a time.
When scalp dandruff is present, a dandruff shampoo for the hair is recommended as well. People who have acne rosacea should treat that condition at the same time.