What is Blepharitis?

Blepharitis, pronounced bleh-fur-RY-tis, means inflammation of the eyelid. The edges of your lids turn red or dark in color and become swollen and scaly. Blepharitis usually affects both eyes. It can happen when a skin condition causes irritation, when you develop an infection or when oil glands become clogged. All of these things can even happen at once.

Blepharitis is a term for inflammation, but it can lead to an infection in your eye. However, most cases of blepharitis aren’t contagious. They aren’t likely to lead to blindness.

Symptoms of Blepharitis

There are several signs and symptoms of blepharitis. They may include:

• Swollen eyelids and/or greasy eyelids.
  Red, irritated eyes that itch or burn.
  Crusting of eyelashes and eyelid corners, making your eyelids stick together.
  Flakes of skin collecting around your eyes and eyelids.
  Dry eye or excessive tearing.
  Excessive blinking.

Other signs and symptoms may include:

• Photophobia (light sensitivity).
• Blurred vision.
• Loss of eyelashes
• Watery Eyes
• Tearing of the eye due to decreased oil secretions
• Gritty and sandy sensation in the eye
• Eye dryness due to less production of oil in the eyes
• Itchiness in the eyelids
• Inability to stand contact lenses for long
• Increased sensitivity to light
• Bloodshot eyes
• Crusting of eyelids
• Red and swollen eyelids
• Dry and flaky patches of skin on the lid
• Freckling of skin around the eyes due to increased shedding of skin cells
• Eyelashes that grow toward your eyes rather than away from them (trichiasis).

Causes of Blepharitis

The most common cause of blepharitis is bacteria. This can happen at the base of your eyelashes or in the glands of your eyelids.

Other causes include:

• Viral or fungal infection
• Allergies
• Eye drop or make-up use
• Blocked oil glands at the edge of the eyelids
• Mite infection (demodex blepharitis)
• Skin problems such as:
• Dermatitis (for example eczema or psoriasis)
• Dandruff
• Rosacea (skin redness)
• Sebaceous (oil) gland issues (seborrheic blepharitis)

How Common is Blepharitis?

A survey of ophthalmologists and optometrists reported that nearly half of the people they see showed symptoms of blepharitis. The condition is common and symptoms are manageable.

Blepharitis typically affects adults and children of both sexes equally. However, one form — staphylococcal blepharitis — mainly affects women and people assigned female at birth (AFAB). This is true of about 80% of cases.

How is Blepharitis Diagnosed?

There’s no single test for blepharitis. Here are a few steps your eye care provider may take to find out if you have blepharitis and what type it is:

• Take a health history: The provider will ask about symptoms and other health conditions to determine your risk factors.
• Do an external eyelid exam: The appearance of your eyelids and intensity of reddening, discharge and swelling will help determine the type and severity.
• Take cultures of discharge: A swab of eyelid secretion sent to a lab can determine contents, including what type of bacteria is present and in what quantity.
• Do a tear test: A sample of tears can determine if dry eye is a contributing factor.
• Do an eyelash exam: Evaluating eyelashes under a microscope can detect mites.
• Perform an eyelid biopsy: Rarely, your provider may need to do a biopsy to rule out skin cancer or other abnormal cells. Your eye care provider will numb your lid with local anesthetic. Then they’ll use a needle to take a sample of cells to examine under a microscope. You may bruise, but you’re not likely to have a scar.

What Complications Can Result from Blepharitis?

You can’t cure blepharitis. However, it can be treated and controlled through proper eyelid hygiene. Left untreated, blepharitis may lead to other more serious eye conditions, including corneal problems, which may be significant.

Complications include:

• Chalazion: A chalazion is a small, painless eyelid bump/swelling.
• Corneal ulcer (keratitis): A sore on your cornea can result from prolonged infection or eyelid swelling.
• Eyelid issues: Eyelashes may shed, grow in odd directions or lighten because of chronic blepharitis.
• Pink eye (conjunctivitis): Some types of blepharitis may turn into chronic pink eye.
• Sty (stye): A sty (stye) is a red, painful eyelid bump near your eyelashes.
• Tear film issues: Tears exist in a delicate balance of mucus, oil and water to keep your eyes moist and protected. If skin or oily debris accumulates and causes irritation, you can develop dry eyes or excessive tearing. Healthy oils secreted by the eyelid margin help protect the tears from evaporating. Dry eye can get worse when blepharitis causes you to excrete unhealthy oils.

How do I Prevent Blepharitis?

Many blepharitis cases aren’t preventable. Some risk factors for blepharitis, such as certain skin conditions, are beyond your control. Here are some steps you can take every day to help with the symptoms:

• Keep your hands, face and scalp clean.
• Try not to touch your itchy eyes or your face. Use a clean tissue if you must touch them.
• Remove all eye makeup before bedtime.
• Wipe away excess tears or eye drops with a clean tissue.
• Wear glasses instead of contact lenses until the condition clears.
• Use artificial tears if you have dry eyes and your provider agrees.
• Use anti-dandruff shampoo to wash your hair.
• Replace eye makeup — eyeliner, eye shadow, mascara — because they may have bacteria in the containers. You want to avoid reinfection.

How is Blepharitis Treated?

If your doctor suspects an infection, they may prescribe an antibiotic ointment. They may also prescribe steroid eye drops to reduce swelling.

In more severe cases they may give you antibiotics tablets or antiparasitic tablets.

Make sure to look after your eye hygiene. To treat blepharitis at home, you can:

• Massage your eyelid towards your nose
• Clean your eyelids
• Use a warm compress for 5 to 10 minutes a few times a day

To clean your eyes, use warm water, or diluted baby shampoo. Mix 1 part shampoo with 10 parts water. Dip a cloth or cotton bud in this liquid, and gently wipe along your whole eyelid. You should include the edge of your eye lids and your eyelashes. You can also ask your pharmacist or doctor about eyelid cleaners.

To apply a warm compress, dip a clean face cloth into very warm water. Squeeze the cloth until its damp and hold against your eye. Do this for over 3 minutes, a couple of times a day.

Reference:

https://www.healthdirect.gov.au/blepharitis

https://my.clevelandclinic.org/health/diseases/10032-blepharitis