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Blepharitis | Dr. Igor Benenson website

Blepharitis

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CHRONIC BLEPHARITIS

This is a bilateral chronic inflammation of the eyelid margins. It is one of the most commonly encountered eye disorders.

Blepharitis commonly occurs when tiny oil glands located near the base of the eyelashes become clogged. This leads to irritated and red eyes. 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 unsightly. But it usually doesn’t cause permanent damage to your eyesight, and it’s not contagious.

Blepharitis symptoms and signs:
•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 upon awakening
•Eyelid sticking
•More frequent blinking
•Sensitivity to light
•Eyelashes that grow abnormally (misdirected eyelashes)
•Loss of eyelashes

The exact cause of blepharitis isn’t clear. It may be associated with one or more factors, including:
•Seborrheic dermatitis — dandruff of the scalp and eyebrows
•A bacterial infection
•Clogged or malfunctioning oil glands in your eyelids
•Rosacea — a skin condition characterized by facial redness
•Eyelash mites or lice

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. Or the eyelid edges may 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 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 symptoms of dry eyes or excess 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.

Treatment:

Self-care measures, such as washing your eyes and using warm compresses, may be the only treatment necessary for most cases of blepharitis. If that is not enough, your doctor may 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 a variety of forms, including eyedrops, creams and ointments. If you don’t respond to topical antibiotics, your doctor may suggest an oral antibiotic.
•Medications to control inflammation. Steroid eyedrops or ointments may help control inflammation. Your doctor may prescribe both antibiotic and anti-inflammatory drugs.
•Medications that affect the immune system. Topical cyclosporine (Restasis) is a calcineurin inhibitor that 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 may be controlled by treating the underlying disease.

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.

Lifestyle and home remedies

Self-care measures such as the following may be the only treatment necessary for most cases of blepharitis.

•Apply a warm compress over your closed eye for several minutes to loosen the crusty deposits on your eyelids.
•Immediately afterward, use a Lid Scrubs to wash away any oily debris or scales at the base of your eyelashes.

•In some cases, you may need to be more deliberate about cleaning the edge of your eyelids where your eyelashes are located. To do this, gently pull your eyelid away from your eye and use Lid scrub tissue to gently rub the base of the lashes. This helps avoid damaging your cornea with the scrub.
•Rinse your eyelids with warm water and gently pat it dry with a clean, dry towel.

It also may be a good idea to stop using eye makeup when your eyelids are inflamed. Makeup can make it harder to keep your eyelids clean and free of debris. Also, it’s possible that makeup could reintroduce bacteria to the area or cause an allergic reaction.

Lubricate your eyes

Try over-the-counter artificial tears. These lubricating eyedrops may help relieve dry eyes.

Control dandruff and mites

If you have dandruff that’s contributing to your blepharitis, ask your doctor to recommend a dandruff shampoo. Using a dandruff-controlling shampoo may relieve your blepharitis signs and symptoms. Using tea tree shampoo on your eyelids each day may help deal with mites. Or try gently scrubbing your lids once a week with a 50 percent tea tree oil, which is available over-the-counter.