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What is blepharitis?

Blepharitis is chronic inflammation of the margins of the eyelids. It can involve the outer or external eyelid, or the inner eyelid, including the eyelashes, conjunctiva (whites of the eye) and the meibomian glands (those that lubricate the eye).

What are the symptoms and signs?

Generally there is a persistent and unsightly redness and scaliness of the skin on and around the eyelid margins. Other problems may include:

  • persistent soreness or swelling of the eyelids, conjunctiva or eyes

  • greasy appearance of the eyelid margins

  • flakes of skin, like dandruff

  • eyelashes that fall out

  • small ulcers on the eyelid

  • crusting and bleeding (if severe)

  • irritation of the eye (from flakes)

  • sensation of ‘something in the eye’

  • grittiness, burning and itching

  • discharge from the lids, causing lashes to glue together during sleep

  • sensitivity to light

  • watery or dry eyes.

What are the main causes?

  • Seborrhoeic blepharitis: associated with seborrhoeic dermatitis

  • Rosacea blepharitis: associated with rosacea of the face

  • Staphylococcus blepharitis: due to infection with the bacterium Staphylococcus aureus

  • Allergic blepharitis: skin reaction to chemicals such as makeup and contact lens products

What are the main causes?

  • Anterior blepharitis—affects the lid margins due to staphylococcus aureus

  • Posterior blepharitis—affects meibomian glands at the rim of the eyelids. Associated with seborrhoeic dermatitis, atopic dermatitis and rosacea

What are the complications of blepharitis?

Apart from infection with Staphylococcus any of the following can occur:

  • styes (infection of an eyelash)

  • meibomian cyst infection

  • conjunctivitis (inflammation of the whites of the eye)

  • ulceration of the conjunctiva (white of eye) or cornea (clear covering of eye)

  • loss of eyelashes

  • scarring of eyelids

  • misdirected eyelash growth (e.g. inwards).

What is the expected outcome?

Blepharitis is a chronic inflammation that is stubbornly resistant to treatment. It can be controlled and sometimes cured in about 6 to 12 months but tends to recur.

What is the treatment?

  • Eyelid hygiene is the key to successful treatment. The crusts and other debris on the eyelids should be gently cleaned with a cotton bud dipped in clean, warm water, a weak solution of sodium bicarbonate (baking soda) or a 1 in 10 dilution of baby shampoo. This should be done once or twice daily depending on the severity. An alternative is to apply a warm water or saline soak with gauze for 20 minutes followed by a rest for 60 minutes before bathing the eyelids again.

  • Formulated eyelid wipes: This new technique involves wiping the eyelids from inside to outside with prepared eye-cleaning, pH-balanced wipes. It is quite expensive but may save using ...

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