Blepharitis: Eye Disease

Blepharitis is inflammation of the eyelids. It is characterized by flaky debris at the eyelash bases. Blepharitis usually causes redness of the eyes and itching and irritation of the eyelids in both eyes. Its appearance is often confused with conjunctivitis and due to its recurring nature it is the most common cause of "recurrent conjunctivitis" in older people. It is also often treated as 'dry eye' by patients due to the gritty sensation it may give the eyes - although lubricating drops do little to improve the condition.

There are two types:
• Anterior blepharitis affects the front of the eyelids near the eyelashes. The causes are seborrheic dermatitis (similar to dandruff) and occasional infection by Staphylococcus bacteria.
• Posterior blepharitis affects the back of the eyelids, the part that makes contact with the eyes. This is caused by the oil glands present in this region.

Staphylococcal blepharitis:
Staphlycoccal blepharitis is a type of external eye inflammation. As with dandruff, it is usually asymptomatic until the disease progresses. As it progresses, the sufferer begins to notice a foreign body sensation, matting of the lashes, and burning. Usually, the primary care physician will prescribe topical antibiotics for staphylococcal blepharitis. This ailment can sometimes lead to a stye, which is caused by the same bacterium, or a chalazion.

Seborrheic blepharitis:
Seborrheic blepharitis, the inherited most common type of blepharitis, is usually one part of the spectrum of seborrheic dermatitis seborrhea which involves the scalp, lashes, eyebrows, nasolabial folds and ears. Treatment is best accomplished by a dermatologist.

Treatment and management:
Many forms of treatment will improve blepharitis, including both antibiotic or steroid eye drops, and certain oral antibiotics. Unfortunately it will usually recur when any treatment is ceased.

Most doctors will therefore recommend a regime of daily eyelid cleaning which is both effective and can be continued safely long-term. Such a regime needs to be convenient enough to be continued lifelong, otherwise the cleaning will stop when symptoms subside.

Therefore simply cleaning the eyelids with a face cloth during every bath or shower may be a good system for a sufferer to adopt. Using dilute baby shampoo with warm water to assist with this is often advised, although probably the most important factor is the mechanical clearance of discharge from the eyelid meibomian glands. Massaging the eyelids firmly during cleaning helps this.

Dermatologists treat blepharitis similarly to seborrheic dermatitis by using safe topical anti-inflammatory medication like sulfacetamide or brief courses of a mild topical steroid. Although anti-fungals like ketoconazole (Nizoral) are commonly prescribed for seborrheic dermatitis, dermatologists and optometrists usually do not prescribe anti-fungals for seborrheic blepharitis.