BLEPHARITIS

Blepharitis is inflammation of the eyelids. Blepharitis usually affects both eyes along the
edges of the eyelids.

Blepharitis commonly occurs when tiny oil glands near the base of the eyelashes become
clogged, causing irritation and redness. Several diseases and conditions can cause blepharitis.

Blepharitis is often a chronic condition that's difficult to treat. Blepharitis can be

uncomfortable and unsightly. But it usually doesn't cause permanent damage to your
eyesight, and it's not contagious.

Causes

The exact cause of blepharitis isn't clear. In some cases, it can spread to another person. It
might be associated with one or more of the following:

 Seborrheic dermatitis — dandruff of the scalp and eyebrows

 Infection

 Clogged or malfunctioning oil glands in your eyelids

 Rosacea — a skin condition characterized by facial redness

 Allergies, including allergic reactions to eye medications, contact lens solutions

or eye makeup
  Eyelash mites or lice

 Dry eyes

Classification

According to its predominant location it is divided into two-

1. Anterior (staphylococcal and seborrheic)

 Anterior blepharitis is characterized by inflammation at the base of the eyelashes .

patient with anterior blepharitis, compared to those with posterior blepharitis are more
likely to be female and younger.

Two variants of anterior blepharitis are identified : staphylococcal and seborrheic

In staphylococcal anterior blepharitis – colonization of the eyelids by staphylococci leads to

formation of fibrinous scales and crust around the eyelashes.

The seborrheic variant- is characterized by dandruff like skin changes around the base of the
eyelids, resulting in greasy scales around the eyelashes.

2. Posterior (meibomianitis)- inflammation of the meibomian gland

Symptoms

Blepharitis signs and symptoms are typically worse in the morning. They include:

 Watery eyes

 Red eyes

 A gritty, burning or stinging sensation in the eyes

 Eyelids that appear greasy

 Itchy eyelids

 Red, swollen eyelids

 Flaking of the skin around the eyes

 Crusted eyelashes
  Eyelid sticking

 More frequent blinking

 Sensitivity to light

 Blurred vision that usually improves with blinking

Complications

If you have blepharitis, you might also have:

 Eyelash problems. Blepharitis can cause your eyelashes to fall out, grow
abnormally (misdirected eyelashes) or lose color.

 Eyelid skin problems. Scarring can develop on your eyelids from long-term
blepharitis. Or the eyelid edges might turn inward or outward.

 Excess tearing or dry eyes. Abnormal oily secretions and other debris shed
from the eyelids, such as flaking associated with dandruff, can build up in your
tear film — the water, oil and mucus solution that forms tears.

 Sty. A sty is an infection that develops near the base of the eyelashes. The result
is a painful lump on the edge of your eyelid. A sty is usually most visible on the
surface of the eyelid.

 Chalazion. A chalazion occurs when there's a blockage in one of the small oil
glands at the margin of the eyelid, just behind the eyelashes. This blockage
causes inflammation of the gland, which makes the eyelid swell and redden.
  Chronic pink eye. Blepharitis can lead to recurrent bouts of pink eye
(conjunctivitis).

 Injury to the cornea. Constant irritation from inflamed eyelids or misdirected

eyelashes can cause a sore to develop on your cornea. N
Diagnosis

Tests and procedures used to diagnose blepharitis include:

 Examining your eyes. Your doctor might use a special magnifying instrument
to examine your eyelids and your eyes.

 Swabbing skin for testing. In certain cases, your doctor might use a swab to
collect a sample of the oil or crust that forms on your eyelid. This sample can be
analyzed for bacteria, fungi or evidence of an allergy.

 Slit lamp examination

Treatment

Self-care measures, such as washing your eyes and using warm compresses, might be all
that's needed for most cases of blepharitis. If self-care measures aren't enough, your doctor
might suggest prescription treatments, including:

 Medications that fight infection. Antibiotics applied to the eyelid have been
shown to provide relief of symptoms and resolve bacterial infection of the
eyelids. These are available in several forms, including eyedrops, creams and
ointments.

If you don't respond to topical antibiotics, your doctor might suggest an oral
antibiotic.

 Medications to control inflammation. Steroid eyedrops or ointments are used

for this, generally only for people who don't respond to other therapies. Your
doctor might prescribe both antibiotic and anti-inflammatory drugs.

 Medications that affect the immune system. Topical cyclosporine (Restasis)

has been shown to offer relief of some signs and symptoms of blepharitis.

 Treatments for underlying conditions. Blepharitis caused by seborrheic

dermatitis, rosacea or other diseases might be controlled by treating the
underlying disease.
Other treatment options, such as using intense pulsed light might unclog the glands. More
study is needed.

Blepharitis rarely disappears completely. Even with successful treatment, the condition
frequently is chronic and requires daily attention with eyelid scrubs. If you don't respond to
treatment, or if you've also lost eyelashes or only one eye is affected, the condition could be
caused by a localized eyelid cancer.