What is blepharitis?
Blepharitis is an eye disease of the lid margins which leads to discomfort, itching, grittiness, discharge and photophobia. The disease is associated with redness of the lid margins, scales and dandruff like material at the base of the eyelashes and sometimes sticky eyes. the condition is very uncomfortable in the long run and gives a very rough and unhygienic look to the eyes.
Blepharitis can present in the lower and upper eyelids equally. The uncertainty of the mechanism of the disease makes the treatment difficult, however some of the best eye drops for blepharitis and other remedies and treatment options will be discussed in our article.
CAUSES OF BLEPHARITIS
What is the Main Cause of Blepharitis?
The causes of blepharitis mainly depend upon the type of blepharitis. However, the main causes include invasion of the eyelid margins by staphylococcal aureus due to poor hygiene or habitual rubbing of the eyelashes.
In case of posterior blepharitis, the normal oil production by the Meibomian gland is disrupted leading to clogging of the Meibomian gland.
TYPES OF BLEPHARITIS
What are the types of blepharitis?
The common classification of blepharitis is anterior and posterior.
- Anterior blepharitis:
- The anterior blepharitis involves the base of eyelashes and can be divided into staphylococcal and seborrheic. The common etiology of staphylococcal blepharitis is related to cell mediated response of cell wall of staphylococcal aureus to the invading antigens. The immune response leads to the formation of peripheral ulceration and anterior blepharitis.
- Posterior blepharitis:
- The posterior blepharitis is caused due to the dysfunction of the Meibomian glands. The melting point of meibum is raised leading to decreased expression of meibum from the glands. The growth of the staphylococcal aureus is increased. There is loss of tear film phospholipid which act as a surfactant resulting in increased evaporation of tears, increased osmolarity and unstable tear film.
SYMPTOMS AND DIAGNOSIS
What are the Common Symptoms of Blepharitis?
The symptoms of blepharitis are usually bilateral and symmetrical. The condition is worsened in the morning however those with dry eye disease may complaint of the worsening condition throughout the day Some of the common symptoms includes.
- Burning of eyes and eyelids
- Grittiness or foreign body sensation
- Crusting at the lid margins
- Redness of lid margins
DIAGNOSING BLEPHARITIS / SIGNS OF BLEPHARITIS
How is blepharitis diagnosed?
The ophthalmologist will do a detailed ophthalmic examination and will look for the following signs.
- Staphylococcal blepharitis: The signs of staphylococcal blepharitis include
- Hard scales and crusting at the base of the lid margins
- Hyperemia of the conjunctiva
- Scaring and notching of the lid margins
- Tear film instability and dry eye disease.
- Atopic conjunctivitis
- Seborrheic blepharitis: The signs of seborrheic blepharitis include
- Hyperemic and greasy lid margins
The signs of posterior blepharitis include
- Excessive and abnormal production of the Meibomian gland secretion along with capping of the Meibomian gland orifices.
- Pouting or recession of the Meibomian gland.
- Pressure on the eyelid margins leads to the secretions which is similar to toothpaste like material.
TREATMENT OPTIONS FOR BLEPHARITIS
What Is The Main Treatment Of Blepharitis?
There is limited evidence for specific treatment of blepharitis. The treatment of anterior and posterior blepharitis is similar, however before starting treatment the patient should be assured that complete treatment of blepharitis is unlikely however the disease level can be controlled effectively with the following treatment options.
- Lid hygiene / life style modification: The lid hygiene should be maintained once or twice a day along with the following guidelines
- A warm compress should be applied for several minutes to soften the adherent crusts and debris.
- Lid cleansing is performed to remove the soften crusts and debris. This is done with a cotton bud or damp bath towel dipped in ward dilute solution of baby shampoo or sodium bicarbonate.
- If extensive Meibomian disease is present, the patient should be guided to roll the finger over the eyelid margin to squeeze the impacted material out of the blocked orifices.
Best eye drops for blepharitis/ benefits of using eye drops
- Antibiotics: Different antibiotics are used for blepharitis which includes fusidic acid, chloramphenicol, azithromycin, bacitracin etc. the antibiotic can be used in drops and ointment form. The ointment is rubbed on the margins of the lids with a cotton bud or clean finger.
- Topical steroids: Steroids are anti-inflammatory drugs. The inflammation of the eyelids will be reduced with topical use of steroids.
- Tear substitutes: Blepharitis can lead to dry eye condition, while treating blepharitis tear substitutes may help in relieving dry eye disease.
Precautions and Side Effects of eyedrops
- Never use any eyedrops without consultation of an ophthalmologist.
- Do not share your eye drops or ointment with anyone else, in order to avoid spread of infection.
- Some eye drops may b stingy temporary, or cause irritation and even blurring of vision.
- The dose prescribed by the consulting doctor should be followed strictly.
Alternative Therapies For Blepharitis
Tea tree oil has been suggested as one of the treatment options for blepharitis. It is available in 50% scrub and 5% ointment formulation.
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