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Blepharitis (Eyelid Inflammation): Causes, Types, Symptoms, Diagnosis & Treatment

A common but undiagnosed condition, blepharitis affects people of all ages and it is more common in people who are above the age of 50 [1] . Blepharitis is an inflammatory condition that mostly affects the eyelids. In this article, we will discuss what causes blepharitis, how it's treated and how it can be prevented.

What Is Blepharitis? [2]

The eyelids are the folds of the skin that cover the eyes and act as a shield by protecting the eyes from dirt and injury. At the edge of the eyelids, there are hair follicles that contain oil glands, these oil glands can become clogged which can trigger certain eye disorders like blepharitis.

What Causes Blepharitis [2]

The exact cause of blepharitis is unknown, but different factors increase the risk of blepharitis, which includes bacterial infection, malfunctioning oil glands, eyelash mites, dandruff of the scalp and eyebrows (seborrheic dermatitis) and allergy reactions to eye medications.

Blepharitis isn't usually contagious and doesn't cause any damage to eyesight.

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Types Of Blepharitis

  • Anterior blepharitis - It occurs on the outside of the eyelids, where your eyelashes are attached. It is caused either due to dandruff on the eyebrows or allergic reactions in the eyes [3] .
  • Posterior blepharitis - It occurs on the inner edge of the eyelids that touches the eyeball. Posterior blepharitis is a result of a malfunctioning oil gland [4] .

Symptoms Of Blepharitis

  • Red eyes
  • Watery eyes
  • A burning or stinging sensation in the eyes
  • Itchy eyelids
  • Red, swollen eyelids
  • Greasy eyelids
  • Sensitivity to light
  • Sticky eyelids
  • A feeling that something is inside the eye
  • Flaking and crusting at the base of the eyelashes.

Risk Factors Of Blepharitis

  • Dandruff
  • Acne
  • Dry skin
  • Poor hygiene
  • Diabetes
  • Old age
  • Cosmetics

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Complications Of Blepharitis

  • Dry eyes - When the debris and oil shed from the eyelids, they can accumulate in your tear film - the water, oil and mucus solution that form tears. This can interfere with the healthy lubrication of your eyelids eventually causing dry eyes [5] .
  • Sty - It is an infection that develops near the eyelash base, causing a painful lump on the outside of your eyelid.
  • Eyelash problems - Blepharitis can lead to falling out of eyelashes.
  • Conjunctivitis - Blepharitis can cause recurrent episodes of conjunctivitis [6] .
  • Eyelid skin problems - Long-term blepharitis causes scarring of the eyelids.
  • Chalazion - It happens when one of the oil glands at the margin of the eyelid gets blocked, which causes the gland to become infected with bacteria [7] .

Diagnosis Of Blepharitis [8]

The doctor will ask about your symptoms, medical history and examine your eyelids through some tests which include the following:

Slit-lamp examination - Slit lamp is a low-power microscope which emits thin-beam light that allows the doctor to look outside of the eyes and eyelids.

Swabbing skin for testing - The doctor may also use a swab to collect a sample of the oil formed in your eyelid. This sample is then analysed to see if there is any bacteria or fungi.

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Treatment Of Blepharitis

  • Antibiotics - Doctors will prescribe antibiotics that may treat blepharitis and provide relief from symptoms. These antibiotics are available in eye drops, cream, and ointments.
  • Intense pulsed light therapy (IPL) - This treatment procedure uses pulses of light to liquefy and release hardened oils that have clogged the glands in the eyelids. IPL reduces eyelid redness and stimulates healthy gland function [9] .
  • Electrochemical lid margin debridement - It is a hand-held electromagnetic device that is used in the eyelid margins. It has a spinning surgical-grade sponge tip that is glided along the eyelids, and it effectively eliminates debris and biofilm, leaving the eyelid margins clean [10] .
  • Thermal pulsation treatment (Lipiflow) - This procedure liquefies and opens the clogged oil glands by gently heating and massaging the inner and outer eyelid. After this treatment, the oil glands resume normal oil production [11] .

Prevention Of Blepharitis

  • Clean your eyes regularly.
  • Remove eye make up before bedtime
  • Avoid touching your eyes with dirty hands.
View Article References
  1. [1] Eberhardt, M., & Rammohan, G. (2017). Blepharitis. InStatPearls [Internet]. StatPearls Publishing.
  2. [2] Bernardes, T. F., & Bonfioli, A. A. (2010, May). Blepharitis. InSeminars in ophthalmology(Vol. 25, No. 3, pp. 79-83). Taylor & Francis.
  3. [3] Guillon, M., Maissa, C., & Wong, S. (2012). Eyelid margin modification associated with eyelid hygiene in anterior blepharitis and meibomian gland dysfunction.Eye & contact lens,38(5), 319-325.
  4. [4] AlDarrab, A., Alrajeh, M., & Alsuhaibani, A. H. (2017). Meibography for eyes with posterior blepharitis.Saudi journal of ophthalmology,31(3), 131-134.
  5. [5] Rynerson, J. M., & Perry, H. D. (2016). DEBS-a unification theory for dry eye and blepharitis.Clinical Ophthalmology (Auckland, NZ),10, 2455.
  6. [6] Morrow, G. L., & Abbott, R. L. (1998). Conjunctivitis.American family physician,57(4), 735-746.
  7. [7] Lindsley, K., Matsumura, S., Hatef, E., & Akpek, E. K. (2012). Interventions for chronic blepharitis.Cochrane Database of Systematic Reviews, (5).
  8. [8] Putnam, C. M. (2016). Diagnosis and management of blepharitis: an optometrist’s perspective.Clinical optometry,8, 71.
  9. [9] Toyos, R., McGill, W., & Briscoe, D. (2015). Intense pulsed light treatment for dry eye disease due to meibomian gland dysfunction; a 3-year retrospective study.Photomedicine and laser surgery,33(1), 41-46.
  10. [10] Geerling, G., Baudouin, C., Aragona, P., Rolando, M., Boboridis, K. G., Benítez-del-Castillo, J. M., ... & Messmer, E. M. (2017). Emerging strategies for the diagnosis and treatment of meibomian gland dysfunction: Proceedings of the OCEAN group meeting.The ocular surface,15(2), 179-192.
  11. [11] Zhao, Y., Veerappan, A., Yeo, S., Rooney, D. M., Acharya, R. U., Tan, J. H., ... & Collaborative Research Initiative for Meibomian gland dysfunction (CORIM. (2016). Clinical trial of thermal pulsation (LipiFlow) in meibomian gland dysfunction with preteatment meibography.Eye & contact lens,42(6), 339.

Story first published: Wednesday, November 6, 2019, 17:42 [IST]
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