Blepharitis is the medical term for an inflammation of the eyelids. There are two basic forms, called anterior blepharitis and posterior blepharitis. The condition is typically caused by bacterial overpopulation on the eyelid skin areas and the blockage of the tiny meibomian glands located at the inner edges of the eyelids where the eyelid actually touches the eye.
Although antibiotics are commonly used to treat blepharitis, it is not contagious and cannot be passed directly to another person. The condition tends to be chronic, and certain other medical problems, such as seborrheic dermatitis and rosacea, may increase your risk of blepharitis as well.
What Causes Blepharitis
The human body normally has bacteria on the skin and also in the intestines, stomach, nose, ears, mouth and genitals. In fact, the average adult’s total body weight includes about 1 to 3 percent bacteria. Many of these organisms are friendly and necessary to health.
For example, the intestinal bacterial microbiome produces most of the brain’s serotonin, regulates hormones, fights infection and manufactures certain vitamins. About three-fourths of the body’s total immune system originates in the gut!
The skin’s bacterial population is also called a microbiome. It’s perfectly normal for certain bacteria to live on the skin. They serve an important immune function and help to fight infection. However, when bacterial populations on the eyelids are too high or are imbalanced, it can contribute to blepharitis.
Anterior and Posterior Blepharitis
Anterior blepharitis occurs when the affected area is where the lashes attach to the eyelid. It’s usually caused by bacteria, but other possible, although less likely, causes include allergies, dandruff from the scalp or eyebrows, excess sebum or skin oil and rarely, mites.
The posterior form affects the inner eyelid where it touches the eye. If the meibomian glands located there become clogged, posterior blepharitis can result. A skin disease called rosacea that causes red bumps to form on the facial skin raises your risk of posterior blepharitis.
As with the anterior form, dandruff may also be a contributing factor, as can oily skin. The meibomian glands secrete the oil that forms the lipid component of tears. This oil is important because it allows the tears to remain on the eye longer. Tears bring oxygen and nutrients to the eye and help to fight microbes.
The symptoms of blepharitis are generally non-specific and can be caused by a number of other conditions. Only an eyecare health professional can accurately diagnose you and tell you for sure what the problem is. Some possible blepharitis symptoms include:
Burning, stinging and itching
A feeling of something in the eye, usually like sand or grit
Swollen eyes or eyelids
Crusty material on the eyelids or lashes, especially on awakening
Tears that look foamy
Never ignore these kinds of symptoms, especially if they persist. Although blepharitis is typically not serious, if left untreated, it can result in blurry vision and the loss of eyelashes. Corneal swelling is possible, too.
A more serious complication is trichiasis, a condition in which the eyelashes grow inwards. Not only is this very painful, it can cause abrasions to the cornea. Moreover, when eyelashes grow inwards, their intended function of protecting the eye from debris is compromised.
Diagnosis and Treatment
Your eye doctor will diagnose blepharitis by evaluating your symptoms and closely examining the eye with a special magnifier tool and a bright light. Your doctor will be looking at the eye structure, eyelids and eyelashes and will also examine the eyelid margins and mebomian glands.
Your doctor may also evaluate the quantity and quality of your tear production.
So how do you treat blepharitis? Treatment for blepharitis includes eye drops and ointments containing antibiotics, such as bacitracin, gentimicin, erythromycin, azithromycin, doxycline, minocycline and sulfacetamide sodium.
Combination eye drops containing a steroid medication with an antibiotic may also be prescribed. Steroids reduce the body’s inflammatory response, helping to ease redness, itching and swelling.
Other treatments include proprietary eyelid cleansers containing hypochlorous acid, which are intended to kill the surface bacteria that can cause and aggravate blepharitis.
Concurrent treatment of other contributing conditions, such as rosacea, dandruff and seborrheic eczema may also help to alleviate the blepharitis. If you wear contact lenses, you should switch to eyeglasses during blepharitis flare-ups.
Women should avoid using eye makeup during this time as well. Eye makeup can introduce more bacteria to the area and make eyelid hygiene more difficult.
In severe blepharitis cases, oral antibiotics may be prescribed. What antibiotics treat blepharitis? Well, often tetracyclines or azithromycin, or the most common. Your eye doctor will also likely prescribe oral antibiotics, commonly cephalexin, if there are any signs of infection of the eye itself.
Sometimes, eye drops containing cyclosporine may be prescribed. Cyclosporine is an immunosuppressant drug that may improve blepharitis symptoms, particularly those of the posterior form. The drug works to reduce the inflammation causing swelling and other meibomian gland dysfunctions in the eye.
Home Care for Blepharitis
It’s very important to follow a home care regimen. It’s crucial to keep your eyelids’ bacterial counts down and also to clean away any crusting. Every morning, wash your hands thoroughly and use a soft cloth dipped in water and a bit of gentle cleanser or shampoo, like baby shampoo, to gently clean your eyelids.
Make sure all crusts are completely cleared away. Be sure to rinse the cleanser off thoroughly. With clean hands, very gently massage your eyelid area to help keep the meibomian glands clear.
Seborrheic Blepharitis and Ulcerative Blepharatis
There are a number of blepharitis subtypes. Two of them are seborrheic blepharitis and ulcerative blepharitis. So what is seborrheic blepharitis? This is when the seborrheic form presents with mild eyelid redness and flaky scales around the eyelash base. It may be linked to seborrheic eczema, an inflammatory skin condition with red, scaly, itchy, flaky patches that most commonly affect the nose, upper back and scalp.
When seborrheic dermatitis occurs on the scalp, it’s called seborrheic dandruff. It differs from ordinary dandruff in that the seborrheic form is inflammatory while the ordinary form is not.
Now that you know what seborrheic bleparitis is, what is Ulcerative blepharitis? This is when hard crusts form around the base of the eyelashes. When the crusts are removed, they leave behind small, pitted sores that tend to bleed and ooze. Other signs of this condition are chronic tearing, eyelash loss and distortion of the frontal eyelid area.
Both can be treated with antibiotics and aggressive home care.
How Long does Blepharitis Last?
Unfortunately, the condition is chronic. It’s often stubborn and persistent as well but with proper medical treatment, you should see a significant improvement within a few weeks. Everyone is different, and dealing with this condition requires consistent care and patience.
Once blepharitis is reined in, it’s important to be vigilant with your medication and home care regimen, or the condition will be likely to quickly recur.
Blepharitis, a leading cause of dry eye, is a relatively common, chronic but typically easily managed eye condition. Serious complications are uncommon but can occur. Always have any kind of eye symptoms evaluated by an eye health professional promptly.
If you’re having any kind of vision problems or if you just need a yearly exam, make an appointment with one of our top-rated eye physicians. Our professional staff will be happy to answer all your questions and welcome you as a new patient.