Blepharitis

Blepharitis is a chronic inflammation of the eyelids and is one of the most common problems we see in the office.  Basically, there are two main causes of Blepharitis:

1.  Staphylococcus (Staph).  This is a bacterial infection of the lids that commonly begins in childhood and continues throughout adulthood.  It produces scales, matter, and chronic redness of the lid margin.  Staph may also cause ulceration of the lids, crusts, broken eye lashes and characteristic collar scales on the lashes.  Also seen are dilated blood vessels, loss of lashes, sties and chalazia.  If left untreated the cornea and conjunctiva can sometimes become infected and scarred.

Treatment is directed at keeping the lids immaculately clean by scrubbing with

Q-tips or a soft wash cloth and a mild baby shampoo.  Special lid scrub preparations are available in pharmacies for this purpose.  Once under control, lid scrubs may be decreased and used only intermittently, depending on the severity of the disease.  Antibiotic drops and ointments are also helpful in controlling this condition.  Only in severe cases are oral antibiotics necessary.  Sometimes anti­inflammatory ointments relieve the bothersome symptoms of irritated, red lids.  Hot packs help dilate the blood vessels and facilitate the healing powers in the bloodstream.  They also help open and clean out the infected pores.  Even with the best of treatment, staph Blepharitis can be a continuing nuisance and a difficult disorder to completely eliminate.

2.  Seborrhea.  This is a commonly seen condition of the eyelids as well.  The lids accumulate greasy, waxy scales along their margins.  The glands of the lid produce abnormal quantities and qualities of tear film, a film that normally coats, protects and lubricates our eyes.  Seborrhea of the lids may be just part of the overall skin disease that affects the areas of the chest, back, scalp, and behind the ears.

Treatment is again directed at lid cleanliness with washes, rinses and hot packs, as outlined above.  Prescription eye drops are also helpful in some cases.  The other affected areas of the body should also be treated with the appropriate shampoos and medicines. Many factors contribute to this disease, including hormones, nutrition, general physical condition and stress.

Separating these two forms of Blepharitis from each other is sometimes very difficult, as they frequently appear together.  This can be further complicated by the involvement of dry eyes, meibomianitis and/or ocular rosacea.