The term blepharitis consists of the root words “bleph-”, meaning eyelid, and “-itis”, meaning inflammation. Simply put, this group of eye diseases refers to inflammation of the eyelid margin and is very common in today’s population. It often occurs on both eyelids and can be chronic, meaning that the disease and its symptoms can recur.
The frequency of the recurrence often increases with age and may be associated with systemic conditions such as acne rosacea.There are a variety of different types of blepharitis and they are listed below.
This subset of blepharitis is caused by an abnormal reaction the body has to Staphylococcus aureus, a bacteria that normally lives on your body. This is associated with scales and crusting on the lashes as well as mild redness on the whites of the eyes.
The lid margin also could become very red or scar and there may be a loss of eyelashes. Treatment includes improved lid hygiene through the use of lid scrubs, warm compresses, and antibiotic-antiinflammatory combination medicines. In more severe cases, crust removal may be needed as an in-office procedure. Artificial tears may be used as well to improve comfort and decrease symptoms.
Associated with seborrhoeic dermatitis, this subset of blepharitis causes greasy and red lid margins. The lashes may be stuck or matted together and there may be scales on the individual’s lashes and skin on the eyelid. The eyelids may also be red. The treatment is similar to infectious blepharitis.
Demodex folliculorum or Demodex brevis mites are two organisms that are associated with this subset of blepharitis. They are found in the lash follicle or in the sebaceous and Meibomian glands on the eyelid. This is associated with a variety of signs, with debris at the base of the lashes being the most common.
Other findings include loss of lashes, changes to the front surface of the eye (the cornea) or inflammation to the white part of the eye. The prevalence of this condition is only up to 20 % in those under 20 years of age but almost 100 % if over 70 years old.
Treatment for Demodex includes the use of tea tree oil to kill the Demodex organisms. A more concentrated solution may be used in-office and the individual will be asked to take home tea tree infused wipes to apply on a daily basis. Crust removal in-office may also be completed if necessary.
This form of blepharitis is a subset of blepharitis specific to inflammation of the Meibomian glands. These glands line the upper and lower edges of the eyelids and are important in providing the eye with the oil component of the tears, preventing quick evaporation. The oil component is especially important in protecting against symptoms of dry eye, a common symptom of this form of blepharitis. In MGD, the glands do not function normally and are altered, either in length or consistency of the secretions. The eye could appear red, feel gritty or have an increase in occurrence of lumps on the eyelid due to blockage or inflammation of the Meibomian glands.
The treatment for MGD includes improved lid hygiene through use of lid scrubs and warm compresses. This will aid in melting the oils within the glands and in improved cycling of the secretions. Expression of the glands in-office can also be done. In some cases, antibiotics may be used. Artificial tears, especially those that are preservative free or a thicker, gel-like consistency, will be used to improve symptoms.