Blepharitis

Nonulcerative Blepharitis, Ulcerative Blepharitis

What is Blepharitis?

Inflammation of the eyelid edges. It can involve the eyelids; eyelashes; meibomian glands (those which lubricate the lid); conjunctiva (white of the eye).

Blepharitis signs and symptoms

  • Redness and greasy scales on the eyelid edges.
  • Eyelashes that fall out.
  • Small ulcers on the eyelid. If the lid edges ulcerate, crusts will form. If crusts are removed, lids will bleed.
  • Irritation of the eye if flakes from the lid fall into the eye.
  • A feeling that something is in the eye. This includes itching, burning, redness, swelling of the lid, sensitivity to bright light and tearing.
  • Discharge from the lids, which glues lashes together during sleep.
  • Sensitivity to light.

Causes

  • Bacterial infection, usually staphylococcal, of the eyelash follicles and the meibomian glands.
  • Allergic reaction (less serious inflammation only).
  • Body lice (rare).

Risk increases with

  • Adults over 60.
  • Medical history of seborrheic dermatitis of the scalp and other body parts.
  • Exposure to chemical or environmental irritants.
  • Crowded or unsanitary living conditions.
  • Poor nutrition.
  • Immunosuppression due to illness or medication.
  • Diabetes mellitus.
  • Acne rosacea.

Preventive measures

  • Wash hands often, and dry with clean towels.
  • Avoid environments that contain dust or other irritating substances.
  • Use hypoallergenic eye makeup.
  • Control seborrhea of the scalp with medicated shampoos.

Expected outcomes

Blepharitis can be stubbornly resistant to treatment, but it is sometimes curable in 8 to 12 months. Recurrence is common.

Possible complications

  • Loss of eyelashes.
  • Ulceration of the cornea (covering of the eye).
  • Scarred eyelids.
  • Stye.
  • Misdirected eyelash growth.

Blepharitis treatment

  • Use warm-water soaks to reduce inflammation and hasten healing. Apply soaks for 20 minutes, then rest at least 1 hour. Repeat as often as needed.
  • Remove scales from the lids each day.
  • Don't wear eye makeup until inflammation subsides.
  • Discontinue soft contact lenses until condition cleared.

Additional Information

Medications

  • Antibiotic ointment or eye drops, which may contain cortisone drugs, may be prescribed.
  • Oral medication may be prescribed in severe cases, such as with acne rosacea.

Activity

No restrictions.

Diet

No special diet.

Notify your physician if

  • You or a family member has symptoms of blepharitis.
  • You have pain in the eye.
  • Your vision changes.
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects.