What is Blepharitis?
Blepharitis is a common and persistent inflammation of your eyelids.
- Itching, irritation, red eyes
- "Gritty" or "sandy" feeling
- Flakes on the lashes
The symptoms described above may not necessarily mean that you have blepharitis. However, if you experience one or more of these symptoms, contact your ophthalmologist for a complete exam.
Bacteria are on the surface of everyone's skin but, in certain individuals, they thrive in the skin at the base of the eyelashes. The resulting irritation, sometimes associated with overactivity of the nearby oil glands, causes dandruff-like scales and particles to form along the lashes and eyelid margins.
For some people, the scales or bacteria associated with blepharitis produce only minor irritation and itching but, in others, it may cause redness, stinging, or burning. Others, however, may develop an allergy to the scales or to the bacteria that surround them. This can lead to a more serious complication, including inflammation of other eye tissues, particularly the cornea.
Blepharitis frequently occurs in people who have oily skin, dandruff, or dry eyes. It can begin in early childhood, producing "granulated eyelids" and continuing throughout life as a chronic condition, or it can develop later in life.
Tests and Diagnosis
Blepharitis can usually be diagnosed by a careful clinical examination.
Treatment and Drugs
Many medications are available for blepharitis, including antibiotics and steroids (cortisone), in drop or ointment form. While cortisone medications often bring quick relief of symptoms, long-term use can cause some harmful side effects. Once the acute phase of blepharitis is overcome (after several weeks), milder medications may be helpful in controlling the eyelid inflammation. However, medications alone are not sufficient; the daily cleansing routine described below is essential.
Daily Cleansing Routine
Blepharitis can be controlled through a careful, regular program of hygiene. Note: Always consult your ophthalmologist before beginning a course of treatment.
- Cleansing materials
- A concave or "cosmetic" mirror (available in most drug stores)
- Cotton balls, a clean washcloth, or commercial lint-free pads
- Cotton-tipped applicators ("Q-tips")
- A mild "no tears" baby shampoo or a commercial eyelid cleansing solution
- A small, clean glass or jar
- Cleansing routine
- The cleansing routine below should be followed at least twice a day at first; perhaps less often as the condition improves.
- Take the clean washcloth and wet it with warm (not boiling) water. Wring it out and place it over the closed eyelids for 5 minutes. This will help to soften the crust and loosen the oily debris. Rewet as necessary to maintain the desired temperature.
- If you are not using one of the ready-made eyelid cleansing solutions, prepare your own by filling the small glass or jar with 2 to 3 ounces of warm water and adding 3 drops of baby shampoo.
- Moisten a cotton ball, clean cloth, or lint-free pad in the commercial cleansing solution or the one you have prepared. Pull down the lower eyelid with your finger and then gently massage the area along the eyelashes for 15 to 30 seconds. Then close the eyes and massage the upper eyelids at the base of the eyelashes for 15 to 30 seconds. Your eyes should not be squeezed tightly shut but closed softly as if you were sleeping.
- Looking into the magnifying mirror, use a Q-tip moistened in the cleansing solution to gently brush the scales away from the eyelids. You can brush either in a horizontal or vertical direction, as long as the granular debris trapped in the eyelashes is effectively loosened and removed. This procedure should take approximately 30 seconds for each eyelid. Alternatively, lid scrubs can be performed with a warm washcloth in a similar fashion while showering.
- Thoroughly rinse your eyes with cool clean water and gently pat dry with a clean towel. Discard any cleansing solution left in the small glass and rinse it clean. If you have been prescribed medication, you should apply it to the eyes and/or eyelids along the lashes, following your ophthalmologist's instructions.
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Reviewed by Jill E. Bixler, M.D.