Blepharitis

Blepharitis (otherwise known as meibomian gland dysfunction) is a common cause of dry eyes and is an inflammation of the rims of the eyelids, which causes them to become red and swollen.  The inflammation and debris from the condition cause obstruction of the meibomian glands responsible for lipid layer of the tear film, thus resulting in evaporative dry eyes.  This is a common condition which can develop at any age but is more common in young children and people over 50. Most people experience repeated episodes followed by periods with no symptoms. It is not possible to catch blepharitis from someone else who has it.

What are the symptoms of blepharitis?

Blepharitis symptoms often come and go.

Symptoms of blepharitis include:

• sore eyelids

• itchy eyes

• a gritty feeling in the eyes

• flakes or crusts around the roots of the eyelashes

• red eyes or eyelids

• eyelids sticking together in the morning when you wake up

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Blepharitis is not usually serious, but can produce a lot of symptoms.  It can also make people unable to wear contact lenses comfortably.

Many people with blepharitis also have dry eye condition where the eyes do not produce enough tears or dry out too quickly (evaporative dry eyes).

Serious complications, such as sight loss, are rare, particularly if recommended advice is followed.

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Treatment for blepharitis

Blepharitis is usually a long-term (chronic) condition, which means once it develops it can cause repeated episodes. 

There is no cure for blepharitis, but establishing a daily eyelid-cleaning routine can help control the symptoms and any dryness can be treated with artificial tear drops. Lid cleaning often needs to be continued indefinitely to prevent recurrence.

More severe cases of blepharitis may require treatment with antibiotic ointment applied to the eyelids or, antibiotic drops for the eyes and, in a few cases, steroid eye drops.

Some patients benefit from antibiotics by mouth, particularly when the blepharitis is associated with a skin condition such as rosacea, These antibiotics are usually required for at least four to six weeks and may need to be continued for many months.

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Step by step guide: lid hygiene techniques

Below is a step by step guide of how to perform these techniques effectively. Please ensure any contact lenses are removed first.

1. Soften oils with hot compress

   Hold a hot flannel or microwavable eye bag firmly onto closed eyelids for 3 minutes to soften the oil in the glands. Take care not to burn your skin

2. Unblock oil glands with massage

  This should always be done immediately after step 1. The aim is to apply pressure to the eyelids to clear the softened oil out of the glands, ready to be cleaned away.

   Use your index finger to apply pressure to the eyelid whilst slowly rolling it towards the eyelashes.

3. Clean edges of eyelids

  Moisten a cotton bud with tap water , or use commercially available eyelid wipes to clean the edges of the eyelids gently but firmly, both where the eyelashes come out of the skin and behind the eyelashes. To clean behind the lashes, you will need to pull the eyelid away from the eye with your finger. This aims to remove any flakes or crusting from the base of the eyelashes, as well as cleaning away excess oils and bacteria.  

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Additional treatment options

In patients where blepharitis is significant, detailed cleaning of eyelid edge with specialised treatment systems such as BlephEx eyelid cleansing, or use of IPL (Intense Pulse Light) therapy or Lipiflow treatment would be required treat the blepharitis and restore normal Meibomian gland function.

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