Blepharitis

Blepharitis

Definition:
Blepharitis (blef-uh-RI-tis) is inflammation that affects the eyelids. Blepharitis usually involves the part of the eyelid where the eyelashes grow.

Blepharitis commonly occurs when tiny oil glands located near the base of the eyelashes malfunction. This leads to inflamed, irritated and itchy eyelids. Several diseases and conditions can cause blepharitis.
Blepharitis is often a chronic condition that is difficult to treat. Blepharitis can be uncomfortable and may be unattractive,
but it usually doesn't cause permanent damage to your eyesight.


Symptoms:
Blepharitis symptoms and signs include:

• Watery eyes
• Red eyes
• A gritty, burning sensation in the eye
• Eyelids that appear greasy
• Itchy eyelids
• Red, swollen eyelids
• Flaking of the skin around the eyes
• Crusted eyelashes upon awakening
• Eyelid sticking
• More frequent blinking
• Sensitivity to light
• Eyelashes that grow abnormally (misdirected eyelashes)
• Loss of eyelashes

When to see a doctor
If you have blepharitis symptoms and signs that don't seem to be improving despite good hygiene — regular cleaning and care of the affected area — make an appointment with your doctor.


Causes:
The exact cause of blepharitis isn't clear. Factors associated with the development of blepharitis include:

• Seborrheic dermatitis — dandruff of the scalp and eyebrows
• A bacterial infection
• Malfunctioning oil glands in your eyelid
• 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
• Certain medication — the severe acne medication isotretinoin (Amnesteem, Claravis, Sotret) can lead to an increase in bacteria on the eyelids and can affect tear production

Blepharitis may be caused by a combination of factors.


Complications:
 If you have blepharitis, you may also experience:

• Eyelash problems. Blepharitis can cause your eyelashes to fall out or grow abnormally (misdirected eyelashes).
• Eyelid skin problems. Scarring may occur on your eyelids in response to long-term blepharitis.
• Excess tearing or dry eyes. Abnormal oily secretions and other debris shed from the eyelid, such as flaking associated with dandruff, can accumulate in your tear film — the water, oil and mucus solution that forms tears. Abnormal tear film interferes with the healthy lubrication of your eyelids. This can irritate your eyes and cause dry eyes or excessive tearing.
• Difficulty wearing contact lenses. Because blepharitis can affect the amount of lubrication in your eyes, wearing contact lenses may be uncomfortable.
• Sty. A sty is an infection that develops near the base of the eyelashes. The result is a painful lump on the edge (usually on the outside part) 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. The gland can become infected with bacteria, which causes a red, swollen eyelid. Unlike a sty, a chalazion tends to be most prominent on the inside of the eyelid.
• 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 may cause a sore (ulcer) to develop on your cornea. Insufficient tearing could predispose you to a corneal infection

Treatments and drugs:
Treatment for blepharitis can include:

• Cleaning the affected area regularly. Cleaning your eyelids with a warm washcloth can help control signs and symptoms. Self-care measures may be the only treatment necessary for most cases of blepharitis.
• Antibiotics. Eyedrops containing antibiotics applied to your eyelids may help control blepharitis caused by a bacterial infection. In certain cases, antibiotics are administered in cream, ointment or pill form.
• Steroid eyedrops or ointments. Eyedrops or ointments containing steroids can help control inflammation in your eyes and your eyelids.
• Artificial tears. Lubricating eyedrops or artificial tears, which are available over-the-counter, may help relieve dry eyes.
• Treating underlying conditions. Blepharitis caused by seborrheic dermatitis, rosacea or other diseases may be controlled by treating the underlying disease.

Blepharitis rarely disappears completely. Even with successful treatment, relapses are common.