PORT ELIZABETH OPHTHALMOLOGIST’S

BLEPHARITIS

Blepharitis is a chronic eyelid inflammatory condition which often affects middle-aged and older patients. The condition occurs in between 20 and 50% of all patients older than 60 years. The cause is poorly understood despite extensive research. We know that it develops due to a combination of inflammation and infection of the glands and eyelid lashes of your eyelids. It is often associated with wit dry eyes. Dry eyes aggravate the inflammation of the eyelids and the two often co-exists in a vicious cycle. Eyelid glands often become blocked because of the above factors leading to the redness of the eyelids.

Recent research has highlighted the importance of parasitic infection in the development of blepharitis. Certain parasites such as Demodex can reside in the eyelash roots and lead to eyelid inflammation. These organisms are highly resistant to conventional treatments.

Symptoms and Signs:

Blepharitis can cause a combination of the following symptoms and signs:

  • Gritty / scratchy / burning sensation
  • Eyelid stickiness (especially in the morning)
  • Eyelid discharge
  • Painful eyes/eyelids, especially at the corners
  • Red eyelids
  • Swollen eyelids
  • Visible crusting on the eyelid lashes
  • Red eyes

Symptoms and Signs:

Blepharitis can cause a combination of the following symptoms and signs:

  • Gritty / scratchy / burning sensation
  • Eyelid stickiness (especially in the morning)
  • Eyelid discharge
  • Painful eyes/eyelids, especially at the corners
  • Red eyelids
  • Swollen eyelids
  • Visible crusting on the eyelid lashes
  • Red eyes

Examination:

Your eye specialist will examine the eyelids under high magnification for signs of eyelid infection and inflammation. A comprehensive examination could also include sampling (pulling) some of the affected eyelashes to be examined for parasites under a light microscope.

Treatment:

There is no consensus as to the ideal treatment strategy. It is crucially important for patients to understand that this is a condition which is likely not to be cured by any treatment. As such, they can expect improvement, but the condition is likely to intermittently recur through flare-ups. The aim of treatment is to eradicate inflammation to such an extent that you as the patient do not experience any more symptoms of the disease.

Home Strategies:

  • Eyelid massage and hygiene – this forms the cornerstone of treatment. Eyelids should be cleaned regularly with baby shampoo diluted in lukewarm water. It is more effective after warm compresses (with a towel) was applied to the eyelids for a minute. Massaging the eyelids so as to try and express blocked eyelid ducts can help to relieve inflammation.
  • Healthy diet – containing high levels of Omega oils. Omega 3 supplements can also be taken as there is some evidence from research that this improves blepharitis.

Medical therapy

  • Topical steroid and antibiotic ointments and or drops can often also be prescribed to treat the infection and inflammation causing the blepharitis. Tablet forms of certain antibiotics such as the Tetracycline family works well for chronic persistent blepharitis. This often needs to be taken as part of long-term treatment (Sometimes indefinitely)
  • Anti-parasitic medication can be given if Parasites are seen in your lash roots.
  • Use lubricating drops to keep the eye moist

Other Therapies

  • Exfoliation treatment with specialized brushes – this is a new modality wherein a fast-rotating brush is used by your eye specialist to clean the surface of the eyelid and its glands. This often leads to blocked glands opening up and inflammation improving.
  • Opening of blocked ducts – occasionally if ducts are blocked, the openings needs to be probed with a small needle-like instrument to allow the blocked secretions to leave the eyelid. What this practice can offer you:
    • Microscopic examination of your eyelashes for parasites
    • Exfoliating therapy for the eyelid margin so This therapy is not covered by medical aids unfortunately and costs will be for the patient.