Blepharitis

Blepharitis is an inflammation of the eyelid margins adjacent to your eyelashes. It is characterized by redness, irritation, and debris associated with this section of your eye.

The symptoms you may experience with blepharitis include tenderness of the area, burning of the eyes, and dryness that tends to get worse as the day goes on. You may notice the debris at the base of the eyelashes, most notably when you wake up in the morning. The debris is termed “scurf” or “collerettes.”

Causes of blepharitis include acute bacterial infection of the eyelids and associated glands, chronic infection of this area, or a localized form of seborrhea. Blepharitis may be associated with various systemic and dermatological conditions such as Rosacea and generalized Seborrhea. These conditions tend to be chronic and require ongoing treatment. We’ll make the specific diagnosis and prescribe the most appropriate treatment for your case of blepharitis.

Treatment for Blepharitis

Treatment is dependent on the specific cause of the condition. For acute cases a short term course of topical antibiotic drops or ointment may be recommended. Occasionally, combination antibiotic and steroid medication must be considered, especially if the patient is highly symptomatic with a great deal of inflammation. A mainstay for the treatment of chronic blepharatits is the use of oral antibiotics, especially those related to tetracycline. These drugs act to kill local bacteria, but they also reduce inflammation and promote the natural secretion of oils from the glands of the lid margins which leads to healing and prevents subsequent episodes of blepharitis. The mainstay of maintenance therapy for blepharitis is the performance of daily or twice daily eyelid hygiene. This includes the use of warm compresses and lid “scrubs.” (see below)

A relatively recent advancement in the treatment of blepharitis has been discovered with the use of Azasite, a macrolide topical antibiotic that has significant anti-inflammatory effects. Other helpful additions to the treatment of blepharitis include the use of other topical anti-inflammatory agents such as Restasis (cyclosporine) topically and oral nutritional supplements containing Omega-3 such as Physician Recommended Nutraceuticals Omega-3 (also providing anti-inflammatory effects). Note that the use of these agents for the management of blepharitis is currently considered an “off label” use and should only be initiated following examination and consultation with your doctor at Krzyzak Eyecare.

An exciting new option for the treatment of blepharitis is the BlephEx system, which is an in office treatment. For more information on this treatment go to: http://rysurg.com/index.php/blephex-page.html

Blepharitis Care

Warm Compress: Soak a clean wash cloth in hot water. Ring the cloth out so excess water is removed. Apply the cloth over the closed eye for approximately two minutes or until the cloth significantly looses heat. A preferred method utilizes a “Bruder Heat Mask” that is warmed in a microwave for about 30 seconds. The mask is placed over both eyes for about 5 minutes providing even heating and extended duration of treatment. Many of our patients report that this is a “spa-like” treatment and feel much better after use of the heat mask. The masks are available at the Krzyzak Eyecare offices.

Lid “Scrub”: Use either pre-medicated eye lid cleansing pads (such as OcuSoft eyelind cleanser) as suggested by your doctor or use a clean wash cloth wrapped around your index finger and dipped in a solution of 50% warm water and 50% baby shampoo. Rub the eyelid margins, close to the area where the lashes enter the lid, in a back and forth motion for approximately 20 seconds. Perform the scrub first to the lower eyelid and then to the upper eyelid of the effected eye(s). Following the lid scrub rinse the lids with warm water to remove any residual debris.

A new a more effective lid hygiene method utilizes Blephadex daily eyelid wipes by Lunovus. Blephadex incorporates a combination of tea tree oil, coconut oil, and a gentle cleanser, but also is a potent anti-microbial that is effective against the most common bacteria associated with blepharitis. Blephadex is available at the Krzyzak Eyecare offices.