Blepharitis - Treatment, Images, Causes, Symptoms and Types

Blepharitis is amongst the most common eye disorders. It is a medical term used to describe an inflammation of the eyelids. Also known as lid margin disease, blepharitis only affects the edges of your eyelids. It commonly develops when the tiny oil glands near the base of your eyelashes become clogged, resulting in irritation and redness. It is often a chronic condition, making it difficult to treat. However, you can manage most of the cases yourself with your doctor’s advice. 

Blepharitis is of two types, depending on its location on your lids. 

1. Anterior Blepharitis: The front edge of the eyelid, where eyelashes emerge, becomes red and swollen. Dandruff on eyebrows and allergic reactions in the eyes can cause anterior blepharitis. 
2. Posterior Blepharitis: It is a more common type of blepharitis that occurs when the oil glands in the inner edge of the eyelid produce oil erratically. 

The symptoms of blepharitis are typically worse in the morning, which includes:

1. Red eyes
2. Watery eyes
3. Dry eyes
4. Feeling like something is in your eye
5. Stinging or burning sensation in the eye
6. Sensitivity to light
7. Blurred vision
8. Itchy eyelids
9. Eyelid sticking
10. Crusting of eyelashes and eyelid corners
11. Greasy eyelids
12. Flaking of skin around the eyes
13. Frequent blinking

The exact causes of blepharitis are not clear. However, there is rarely a single cause. Things that can cause blepharitis include:

1. Clogged oil glands in your eyelids
2. Infection
3. Excess bacteria
4. Eyelash mites
5. Meibomian Gland Dysfunction (MGD)
6. Dry eyes
7. Hormone problems

You are at a higher risk of getting blepharitis if you have:

1. Seborrheic dermatitis (dandruff on the scalp and eyebrows)
2. Skin conditions like rosacea
3. Allergies
4. Oily skin

Most causes of blepharitis are not preventable. However, these following lifestyle changes can minimise its symptoms:

1. Keep your hands, face, and eyelids clean. 
2. Remove eye makeup before going to bed.
3. Avoid touching itchy eyes or use clean tissue.
4. Wipe away excess eye drops with clean tissue.
5. Replace your contact lenses with glasses until the condition clears.
6. Replace your eye makeup to avoid reinfection.

Your doctor will ask you about your symptoms and other health conditions during the diagnosis. The tests used to diagnose blepharitis include:

1. External Eyelid Exam: Examining the intensity of redness, swelling, and discharge from the eyelids can help your doctor determine the blepharitis type and severity. 
2. Swab Test: The test uses a swab to collect a sample of eyelid secretion sent to a lab to analyse the type of bacteria present. 
3. Eyelash Exam: This test involves examining eyelashes under the microscope to detect mites.
4. Tear Test: A sample of tears is used to determine if dry eye contributes to blepharitis. 

How to Prepare for Doctor Consultation?

You may want to consult an optometrist or ophthalmologist if you suspect an eye problem. While preparing for the consultation, make sure to take a prior appointment and make a list of:

1. The symptoms you are experiencing
2. All the medications you take
3. Questions to ask your doctor

What can You Expect from the Doctor?

The doctor may physically examine your eye and ask certain questions like:

1. What symptoms do you experience?
2. Do the symptoms come and go?
3. Do you have any other diseases?
4. Do you wear contact lenses?
5. Have you changed your cosmetic or shampoo brands recently?
6. Have you had any recent eye infections?

You can ask the following questions to your doctor about blepharitis:

1. What is the cause of my symptoms?
2. How can I prevent its progression?
3. What tests will I need for diagnosis?
4. Are there any risks involved?
5. What is the treatment for blepharitis?
6. Do I need special cleaning of my eyes and contact lenses?
7. Do I need a follow-up visit? 

The treatment depends on the type of blepharitis you have. After conducting tests to diagnose blepharitis, your doctor may prescribe treatments including:

1. Antibiotics: To lessen the irritation, the doctor may prescribe an antibiotic ointment like bacitracin ophthalmic or antibiotic eye drops like polymyxin B and trimethoprim. 
2. Anti-Inflammatories: Your doctor may add anti-inflammatories to your treatment if you do not respond to other therapies. Steroid eye drops or ointments are prescribed to reduce inflammation. 
3. Artificial Tears: Over-the-counter artificial tears can help relieve dry eyes. 
4. Antiviral Drugs: Antiviral drugs can help treat acute blepharitis. 
5. Immunomodulators: In cases of posterior blepharitis, your provider may prescribe an immunomodulatory drug to reduce inflammation. 
6. Treatment for Underlying Causes: Eye drops for dry eyes or shampoo for dandruff can treat the root causes of blepharitis, like seborrheic dermatitis, rosacea, or other diseases. 

You can also use certain home remedies to soothe the symptoms. 

1. Avoid using eye makeup: You should avoid using eye makeup until the infection is under control to lessen the irritation in the eyes.
2. Keep your eyelids clean: Wash your eyelids with a solution of baby shampoo and water. Make sure to use a clean cloth for each eyelid to avoid the spread of bacteria from one eye to the other. 
3. Use warm compresses: Wet a clean washcloth with warm water and place it over your eyelids. Repeat the process until the oily debris is easily wiped away. 

Please Note: The selection of the treatment approach is based on the severity and type of blepharitis and your doctor’s opinion. 

If left untreated, blepharitis can lead to other serious eye conditions. The complications of blepharitis include:

1. Chalazion: A small, painless eyelid swelling.
2. Stye: A red, painful eyelid bump near the eyelashes.
3. Chronic pink eye: Some blepharitis can lead to recurrent bouts of pink eye.
4. Eyelash issues: It can cause your eyelashes to fall out or grow abnormally.
5. Dry eyes or excessive tearing: Abnormal oil secretions or other debris can build up in your tear line - mucous, oil, and water that keeps your eye moist and protected. This can irritate your eyes, leading to dry eyes or excessive tearing.
6. Cornea Inflammation: A sore on the cornea can result from eyelid swelling, infection, or misdirected eyelashes.

Disease Progression of Blepharitis

1. Stage 1: Inflammation of the lid margin with little to no build-up.
2. Stage 2: Inflammation of lid margin and lash follicle swelling with mild build-up.
3. Stage 3: Inflammation of lid margin and lash follicle swelling with moderate build-up, causing early lash misdirection.
4. Stage 4: Inflammation of lid margin and lash follicle swelling with heavy build-up, causing lash misdirection and ingrown lashes.