What is Blepharitis ?
Blepharitis is a common inflammation of the eyelids. It usually affects the edges (margins) of the eyelids. It is not usually serious, but may become an uncomfortable, irritating problem. Blepharitis is typically persistent (chronic). Both eyes are usually affected.
2 basic forms of Blepharitis :
It's common to have a mixture of both anterior and posterior forms of blepharitis at the same time, but in different degrees of severity. People with blepharitis may experience a gritty or burning sensation in their eyes, excessive tearing, itching, red and swollen eyelids, dry eyes or crusting of the eyelids. For some people, blepharitis causes only minor irritation and itching. However, it can lead to more severe symptoms, such as blurring of vision, missing or misdirected eyelashes, and inflammation of other eye tissue, particularly the cornea. |
Signs and Symptoms
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Causes and Risk Factors
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.
3 main types of blepharitis:
1. Staphylococcal blepharitis
-Staphylococcal blepharitisThis type of blepharitis is thought to be caused by a germ (bacterium) called staphylococcus. This bacterium commonly lives in low numbers on the skin without doing any harm. However, in some people, it seems that this bacterium causes an infection of the eyelids, resulting in blepharitis. Exactly why or how this happens in some people is unclear.
2. Seborrheic blepharitis
-Seborrheic blepharitisSeborrheic blepharitis is closely associated with a skin condition called seborrheic dermatitis. In seborrheic dermatitis, the affected skin becomes oilier and can become scaly. Seborrheic dermatitis typically causes bad dandruff and sometimes a rash, commonly on the face and upper body. The underlying cause of seborrheic dermatitis is not clear. A type of yeast called Malassezia furfur is involved. However, it is not just a simple skin infection and it is not contagious, if you cannot catch this condition from others. This yeast lives in the oil (sebum) of human skin in most adults and usually does no harm. However, in some people the yeast seems to trigger an inflammatory reaction, causing the blepharitis.
3. Meibomian blepharitis
-Meibomian blepharitisThis is also known as Meibomian gland dysfunction. The tiny Meibomian glands in the eyelids lie just behind the eyelashes. You have about 25-30 Meibomian glands on each upper and lower eyelid. They make a small amount of oily fluid which comes out on the inside of the eyelids next to the eye. This oily fluid forms the outer layer of the tear film which lubricates the front of the eye. People with Meibomian blepharitis are thought to have a slight problem with their Meibomian glands and the fluid they produce. This may lead to eyelid inflammation. This also explains why people with Meibomian blepharitis often have dry eyes as the fluid they make may not be adequate to lubricate the eye.
-Staphylococcal blepharitisThis type of blepharitis is thought to be caused by a germ (bacterium) called staphylococcus. This bacterium commonly lives in low numbers on the skin without doing any harm. However, in some people, it seems that this bacterium causes an infection of the eyelids, resulting in blepharitis. Exactly why or how this happens in some people is unclear.
2. Seborrheic blepharitis
-Seborrheic blepharitisSeborrheic blepharitis is closely associated with a skin condition called seborrheic dermatitis. In seborrheic dermatitis, the affected skin becomes oilier and can become scaly. Seborrheic dermatitis typically causes bad dandruff and sometimes a rash, commonly on the face and upper body. The underlying cause of seborrheic dermatitis is not clear. A type of yeast called Malassezia furfur is involved. However, it is not just a simple skin infection and it is not contagious, if you cannot catch this condition from others. This yeast lives in the oil (sebum) of human skin in most adults and usually does no harm. However, in some people the yeast seems to trigger an inflammatory reaction, causing the blepharitis.
3. Meibomian blepharitis
-Meibomian blepharitisThis is also known as Meibomian gland dysfunction. The tiny Meibomian glands in the eyelids lie just behind the eyelashes. You have about 25-30 Meibomian glands on each upper and lower eyelid. They make a small amount of oily fluid which comes out on the inside of the eyelids next to the eye. This oily fluid forms the outer layer of the tear film which lubricates the front of the eye. People with Meibomian blepharitis are thought to have a slight problem with their Meibomian glands and the fluid they produce. This may lead to eyelid inflammation. This also explains why people with Meibomian blepharitis often have dry eyes as the fluid they make may not be adequate to lubricate the eye.
How is Blepharitis diagnosed?
- Blepharitis can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on the eyelids and front surface of the eyeball, may include:
- Patient history to determine any symptoms the patient is experiencing and any general health problems that may be contributing to the eye problem.
- External examination of the eye, including lid structure, skin texture and eyelash appearance.
- Evaluation of the lid margins, base of the eyelashes and Meibomian gland openings using bright light and magnification.
- Evaluation of the quantity and quality of tears to check for any abnormalities.
2. An optometrist can determine the type of blepharitis based on the appearance of the eyelid margins. The different types and symptoms are as follows:
- Staphylococcal blepharitis patients frequently exhibit mildly sticking eyelids, thickened lid margins, and missing and misdirected eyelashes.
- Seborrheic blepharitis patients have greasy flakes or scales around the base of eyelashes and a mild redness of the eyelids.
- Meibomian blepharitis patients have a blockage of the oil glands in the eyelids, poor quality of tears and redness of the lining of the eyelids.
Treament
There are several types of artificial tear drops and gels with different ingredients. Occasionally, some people find one type may irritate. A change to a different preparation may help if the first does not suit.
Note: a three-month course of antibiotics is typically used in the treatment of blepharitis. |
No alternative medicine treatments have been found to conclusively ease the symptoms of Blepharitis. However, a diet rich in omega-3 fatty acids or supplements containing omega-3 fatty acids may be helpful for blepharitis associated with rosacea. Omega-3 fatty acids are found in foods such as salmon, tuna, trout, flaxseed and walnuts.
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