Blepharitis

Definition
An inflammation of the eyelid edges.

Causes, incidence, and risk factors
Blepharitis has multiple causes but is usually caused by seborrheic dermatitis, a bacterial infection, or a combination of both, allergies, or infestation with lice (in the eyelashes). Blepharitis is characterised by excess oil production in the glands near the eyelid, which creates a favourable environment for the growth of bacteria. Eyelids appear red and irritated, with scales that cling to the base of the eyelashes. Blepharitis may be associated with repeated sty's and chalazion. Risk factors are poor hygiene, seborrheic dermatitis of the face or scalp and allergies.

Prevention
Cleaning eyelids carefully will help restore the normal environment for the eyelid.

Symptoms

• crusty and reddened eyelids
• swollen eyelids
• itching and burning eyelids
• a granular sensation when blinking
• loss of eyelashes
• eyes, bloodshot
• eye pain

Signs and tests
An examination of the eyelids is usually sufficient to diagnose blepharitis.

Treatment
Depending on the cause, medications applied to the eyelid (topical), such as: antibiotics and/or corticosteroid (see corticosteroids - topical - low potency) will treat the infection and reduce the swelling. Careful cleansing of the eyelids with a clean lint-free cloth soaked in warm water will help to remove the crusts. Often, a mild baby shampoo can also be used for cleansing.

If present, seborrheic dermatitis should be treated. Lice may be eradicated by smothering them with petroleum jelly applied to the base of the lashes.

Expectations (prognosis)
The probable outcome is good with treatment.

Complications
Call for an appointment with your optometrist or GP if symptoms worsen or do not improve after careful cleansing of the eyelids for 2 or 3 days. Be aware of complications such as:

• Prolonged infection
• Injury to the eye tissue (corneal ulcer) from irritation
• Inflammation of the lining of the eye (conjunctivitis)
• Loss of eyelashes
• Scarring of the eyelids

Granulated Eyelids, Blepharitis
Blepharitis, or granulated eyelids, is a common problem that produces a red-rimmed appearance to the edge of the eyelids. This condition is often chronic and involves both the upper and lower lids.

Common symptoms include dandruff-like scales or grainy material adhering to the lashes and lid edges. The symptoms can include itching, burning, sticky, crusted eyelids on awakening, and a feeling of "something in the eye."

Granulated lids cannot be cured, but the symptoms can be controlled with treatment.

Treatment may consist of cleaning and removing any scales from the lid edges, frequent shampooing of the scalp and eyebrows, and ointment applied at bedtime when indicated.

Follow these instructions:

1. Apply a warm, moist hand towel to the closed lids for five to 10 minutes in the morning and at bedtime.

2. Following the warm compresses at bedtime, mix a solution of half "No Tears" baby shampoo and half warm water in the cap from a bottle of the baby shampoo. Put the solution on a wet wash cloth or cotton tip applicator, and gently scrub from side to side on the upper eyelids and lashes for 15 to 20 seconds.

3. Pull the lower lid down and away from the eyeball and gently scrub side to side along the edge of the lower eyelid and lashes for 15 to 20 seconds. Avoid scrubbing the eyeball.

4. Rinse the cloth and clean any remaining shampoo from the lids with clear, warm water.

5. When instructed, place a 1/4-inch strip of ointment under the lower lids at bedtime and rub the excess onto the lid edges.

6. If you have a problem with dandruff of the scalp and eyebrows, shampooing frequently with a shampoo containing selenium sulphide or pyrithione zinc (such as Head & Shoulders) will be helpful.

7. Continue this treatment for two to three weeks or until the problem is controlled. After an initial treatment period, it will most likely be necessary to continue to use warm compresses and lid scrubs from time to time to keep the lid scales under control.

http://www.eye-care.org.uk

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