Blepharitis is an inflammation of the eyelids most commonly of the eye lid margins near to the eye lashes.
There are a number of causes of blepharitis including infection and allergy.
Anterior blepharitis is commonly caused by a staphylococcal bacterial infection of the eye lash follicles. In some cases this leads to a more acute infection which is known as a stye. In the elderly, anterior blepharitis can also be caused by infestation of a mite called demodex. The symptoms of anterior blepharitis include crustiness of the lid margins and eye lashes as well as red, sore eyes and sometimes itchy eyes.
Posterior blepharitis is caused by a blockage or infection of the meibomian glands situated in the eye lid margins. This can also be caused by staphylococcus. Because the natural oily secretion is abnormal or reduced, the quality of the tears is affected and this is a very common cause of dry eye.
Usually your practitioner will usually ask you to carry out a regime of Eyelid Hygiene for one or two weeks but may at the same time prescribe an antibiotic eye ointment.
There are two “eyelid hygiene” steps that need to be carried out on a daily basis.
1. Heat and massage
Having washed your hands, take a large clean wash cloth or hand towel and soak it in very warm water. Apply this to the closed eye lids and gently massage through the towel. This should be carried out for 4 to 5 minutes.
Alternatively you may use an Eye Bag which is designed for this purpose and is heated in your microwave.
Lipiflow treatment is the most advanced treatment for posterior blepharitis (meibomian gland dysfunction) and this is available in the practice.
2. Eyelid ‘scrubs’
After carrying out the warm compress a procedure called “lid scrubs” should be carried out. Firstly, wash your hands. Using a pad such as Blephaclean (or Blephasol), close your eyes and gently scrub your eyelid margins using a side-by-side motion for 20 to 30 seconds. This is to ensure you remove all the built up oils and crustiness. Finally, rinse your eyelids with cold water.
Alternatively you may use a cotton-wool bud (Q-Tip) dipped into either (a) a dilute solution of Johnson's Baby Shampoo (1 part shampoo to 5 parts boiled water) or (b) a dilute solution of sodium bicarbonate bought from a pharmacy (One tea spoon of sodium bicarbonate to one pint of water).
When applicable Barnard Levit Optometrists carry out an in-practice treatment to clean the eye lids called BlephEx.
Therapy using medication
In addition to the eyelid hygiene regime your practitioner may prescribe you a course of an antibiotic eye ointment for 7 to 10 days. For severe cases that do not resolve, Dr Barnard, who is registered with the GOC as an Independent Therapeutic Prescriber may prescribe a course of oral antibiotic.
Blepharitis tends to reoccur so it is advisable to continue with the eyelid hygiene