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Blepharitis is a common condition that can present acutely or chronically. Chronic or acute blepharitis results in dry, red, irritated eyes. A prominent feature of this condition is scales along the eyelashes. The scales may be related to dandruff or eczema. In others the blepharitis is related to chronic Staph infections. When present for a long time the scales cause thickening of the eyelids and clogging of the eyelid oil glands. The glands are important in secreting the lubricating components of the tears. The condition is often a result of acne rosacea and can be treated with medications used to control that disease. Although there is generally no cure, blepharitis is usually easy to control. Treatment must be done each day.
The following may be effective:
Hot Compress: Very important in the acute phase. Used two or three times a day. Best way – take a small, new potato and heat the potato in a microwave, then put the potato into a washcloth soaked with hot water, and place over the lids.
Massage: Place the hot compress over the eyes while gently massaging the lids down from the top and up from the bottom. The heat melts the material that clogs the glands and the massage expresses the glands.
Lid Scrubs: Clean the lids with either diluted baby shampoo (1:10) or with specially made pads that contain a mild cleanser that won’t irritate the eyes.
Antibiotic/Steroid Ointment: If the condition is significant we might prescribe an antibiotic/steroid combination ointment to place on the lids which will also fall into the eyes. This usually provides dramatic relief. Steroids should not be used long term unless advised and monitored by your doctor. They can lead to serious consequences like glaucoma, cataract, or super infection unless appropriately monitored.
Doxycycline or Tetracycline Pills: In severe or very chronic cases, oral medications may be used to control the blepharitis. They may be used to rapidly control the condition or in low doses daily to eliminate flare-ups.
What Will Happen If I Don’t Treat It?
If the glands become clogged, the eyelids become red and irritated. Eventually, the quality of your tears become compromised and a dry eye ensues. If the condition becomes chronic, the lids thicken and the glands which secrete the lubrication portion of our tears stop functioning properly. The lids, conjunctiva, and the cornea may become involved. The symptoms vary from a mild red eye, to an irritated dry eye, to severe corneal involvement.
In addition, the glands of the eyelid may become infected with a resultant stye (external hordeolum) or clogged with hardening of material further back. This non-infectious infiltration of the gland is known as a Chalazion. They often result after the presence of a stye. Treatment is the same hot compress and massage. Most Chalazions will respond to hot compress and massages. Treatment may take 2-3 weeks. If hot compress and massage are either impractical or fail to resolve the problem then steroid/antibiotic drops may be used or surgical removal may be advised. Remember, most cases of blepharitis are chronic. Thus, hot compress and lid scrubs may be a life long event.
Is There Anything Else That I Can Do to Eliminate Symptoms?
Avoid eye irritants and control ocular allergies. Those working in dusty conditions are particularly susceptible.