Blepharitis refers to inflammation of the
eyelids, particularly at the lid margins. It's a common disorder and
may be associated with a low-grade bacterial infection or a generalized
skin condition.
The condition can be difficult to manage because it tends to recur.
Another term for blepharitis is granulated eyelids. Angular blepharitis
is a term used to describe blepharitis which primarily affects the
outer corners of the eyelids.
Classification:
There are two types of blepharitis:
1.Anterior blepharitis affects the anterior margin (front) of the
eyelid near the roots of the eyelashes. The causes are seborrheic
dermatitis (similar to dandruff) and, more rarely, infection by
Staphylococcus bacteria.
2.Posterior blepharitis affects the posterior margin (back) of the
eyelids, the part that makes contact with the eyes. This is caused by
the oil glands present in this region and can be exacerbated by scalp
dandruff. It is by far the most common type of blepharitis.
Cause:
Blepharitis involves the eyelid margins, where the eyelashes grow and
the openings of the tiny oil glands near the base of the lashes are
located. There may be involvement of the outer edges of the eyelid
margins adjacent to the skin or/and the inner edge of the eyelid that
comes into contact with the eyeball. Changes in the skin of the eyelids
or the surface of the eye itself are usually secondary to the
underlying disorder of the lid margins.
1.The cause of most cases of blepharitis is a malfunction of the oil
glands of the lids. There are about 40 of these glands in each of the
upper and lower lids. When these oil glands produce too much, too
little, or the wrong types of oils, the eyelid margins can become
inflamed, irritated, and itchy. Acne rosacea, a generalized illness of
oil glands, is sometimes the underlying cause of this process.
2.There are some types of blepharitis that are due to disorders of the
lid margin around the lashes. These include seborrheic blepharitis,
which is similar to dandruff of the scalp, and infection of the lash
base by Staphylococcal bacteria.
3.Allergies can also cause blepharitis. These include sensitivities to
substances coming into direct contact with the lid margins, including
mascara and contact lens solutions. Various sprays, exposure to
animals, environmental chemicals, or airborne allergens can also cause
blepharitis.
4.Less commonly, inflammation of the lids can be caused by a primary
infection of the eyelids by bacteria or infestation of the lashes by
tiny mites or head lice.
5.Blepharitis may also be caused by systemic (affecting areas
throughout the body) medical conditions or skin cancers of various
types.
Symptoms:
1.Present in eyelids of both the eyes.
2.Itchy eyelids.
3.Watering from eyes.
4.Sometimes, sensation of dryness in the eyes.
5.Burning and gritty sensation in the eyes.
6.Foreign body sensation in the eyes.
7.Sensitive to light.
8.Swollen eyelids with redness.
9.Red eye lid margins.
10.Matting of the lashes or eyes "glued together" in the morning,
11.Eyelashes that grow abnormally,
12.Loss of eyelashes,
13.Mild scarring of the eyelid margins,
14.Mild ulceration of the lid margins,
15.Dry and flaky patches of skin on the lid, and
16.Dandruff of the lashes and eyebrows.
Diagnosis:
Blepharitis can be usually diagnosed by a physician based on the
history as given by the patient and physical examination.
The physical examination should place special emphasis on evaluation of
the eyelids, lid margins, base of the lashes, oil gland openings, tear
quantity and quality, and front surface of the eyeball using a slit
lamp, which allows a magnified view with sufficient illumination.
Complication:
1.Recurrent styes.
2.Chalazion
Treatment:
Blepharitis can be difficult to manage because it tends to recur.
Depending on the type of blepharitis you have, treatment may include
applying warm compresses to the eyelids, cleansing them and/or
massaging the lids.
If blepharitis makes your eyes feel dry, your doctor also may prescribe
artificial tears or lubricating ointments.
The warm compress portion of treatment is designed to loosen crusts on
your eyes before you cleanse them; it can also warm up and loosen the
plugs blocking the meibomian glands.
Cleansing the eyelids is essential to blepharitis treatment. Your
doctor will recommend what cleansing agent to use, such as warm water
only, salt water etc.
Clean eyelids by following these steps: