Blepharitis. What is it and how is it treated?

Blepharitis is an inflammation that occurs at the edge of the eyelids causing redness, peeling and swelling of the eyelids. In most cases, the glands located in the eyelids produce excess fat and this fat accumulates in a caseous manner, which causes an inflammation or favors the appearance of bacteria or even parasites.

It is usually a chronic disorder and complicated to treat, however, it does not usually cause permanent damage to vision and is not contagious. Blepharitis can affect people of all ages, although it is more common in people over 50.

There are several types of blepharitis:

– Anterior: affects the outside of the eyelid, where the eyelashes are located. It is usually caused by an excess of fat or by the proliferation of bacteria.

– Posterior: it affects the inner part that is in contact with the eye and is caused by a dysfunction of the Meibomian glands, which are responsible for producing the lipid component of the tear.

– Mixed: the two types mentioned above are produced simultaneously.

The common symptoms that can be associated with blepharitis are usually:

• Redness of the palpebral edge
• Dilated vessels on the edge of the eyelid
• Dryness of the eye that manifests itself as a foreign body sensation (grit) and inflammation of the eye surface.
• Tearing.
• Diffuse loss or abnormal growth of eyelashes (deviated eyelashes).
• Inflammation of the eyelids.

The most common causes of blepharitis are:

• Obstruction or malfunction of the glands located on the edge of the eyelid.
• Excess fat on the palpebral edge, which creates a favorable environment for the proliferation of bacteria and causes the so-called staphylococcal blepharitis.
• Seborrheic dermatitis, which produces dandruff on the scalp, eyebrows or even eyelashes.
• Other skin disorders, such as rosacea or psoriasis.
• More rarely, parasites that grow on the palpebral edge.

Blepharitis is a chronic eye disease with potential for repeated episodes that can become severe if not detected early. Therefore, it is important to have proper hygiene habits, such as daily cleaning of the palpebral edge to prevent the development of the disease.

The treatment will depend on the phase in which the patient is, but initially it usually consists of local heat and massages on the eyelid for at least 5 minutes and daily hygiene of the palpebral edge and eyelashes with specific products (soaps or ophthalmic wipes) in order to remove excess fat.

In the case of staphylococcal blepharitis, in addition to palpebral hygiene, it may be necessary to apply an antibiotic ophthalmic ointment on the edge of the eyelids.

If blepharitis is associated with dry eyes, the use of artificial tears is recommended.

Sometimes it is recommended to follow a diet rich in Omega 3 fatty acids or nutritional supplements containing them due to their anti-inflammatory properties.

If blepharitis is caused by parasites, such as demodex, it may be necessary to clean the palpebral edge and eyelashes with solutions containing tea tree oil.

In cases where blepharitis is caused by nits, these can be removed with an antibiotic or petroleum jelly eye ointment and then manually removed with tweezers.

Blepharitis associated with other skin diseases, mainly rosacea, may require treatment with oral antibiotics for a prolonged period of time.

In cases of subsequent blepharitis that are difficult to manage, an innovative treatment is indicated, which consists of the application of intense pulsed light (IPL) at the palpebral level, which would also improve the symptoms of dry eyes associated with this pathology.

As it is a chronic pathology, it is advisable to have regular controls with the ophthalmologist to monitor its evolution.

Blepharitis can produce complications, such as

• Chalation: it is produced by an obstruction of the sebaceous glands of the eyelid and a subsequent increase in their size due to inflammation. The secretion is retained inside and then this nodule appears.
• Stye: This is a small lump, red and painful, located on the eyelid and may contain pus.
• Conjunctivitis or corneal ulcers.

Is blepharitis contagious?

No, it is not contagious.

My blepharitis is not getting better, can it be chronic?

In most cases it is chronic, so be sure to visit your ophthalmologist to control it in your specific case.

Can blepharitis be treated with chamomile or other home remedies?

It is advisable to follow a specific treatment as long as it is indicated or you have consulted your ophthalmologist.

The use of chamomile in compresses to apply the heat can be useful depending on the type of blepharitis. The use of other home remedies is not recommended.

How to clean the eyes in case of blepharitis?

It depends on the type of blepharitis you have: if it is previous blepharitis, it is important to clean the palpebral edge and eyelashes with soaps or specific wipes for eye use. If it is posterior or mixed blepharitis, heat and massages should be applied to facilitate the elimination of the fat generated by the glands of the eyelid.

How is seborrheic blepharitis cured?

Blepharitis is NOT cured, it is a chronic pathology. The objective of the treatment is to keep the pathology under control and avoid complications.

How is allergic blepharitis cured?

You should visit your ophthalmologist for an evaluation and rule out other causes of blepharitis. The allergy usually produces redness and peeling of the eyelid skin (eczema) and not blepharitis.

Can I wear makeup if I have blepharitis?

It is not recommended the use of makeup, especially in cases of acute inflammation. It is mainly inadvisable to use eyeliners and mascara because they are in direct contact with the affected area.

What is the difference between blepharitis, stye and chalazion?

Blepharitis is the inflammation of the edge of the eyelid. The stye is produced when one of the glands of the eyelid is obstructed associated with acute inflammatory signs (red, edematous and painful lump). When this obstruction has not been resolved and a cyst has formed, it is called a chalation.