Blepharitis

Blepharitis is a chronic condition involving inflammation of the eyelids from a range of reasons. Common causes include build up of bacteria, rosacea, Demodex mites, and more. It is very common in older adults but can occur at any age.

The eyelids contain Meibomian glands which are responsible for creating the oily layer of our tears – this layer is responsible for keeping the tears on the eye longer. When this part is reduced or missing, tears evaporate faster. This can occur when the glands are blocked, damaged or dead and results in poor tear production.

We often forget or do not even realize that we need to keep our eyelids and lashes clean – eyelid hygiene should be part of our daily routine just like our oral care otherwise bacteria, dust, allergens, mites and more continue to build up on the eyelashes, causing inflammation and destruction of important structures which will eventually lead to symptoms.

Symptoms

Redness, irritation, crusting, dry eyes, itching, loss of eyelashes, frequent styes, excessive tearing, blurred vision especially in the morning

Treatment

The most important treatment is daily “eyelid hygiene”
  • This involves warm compresses and proper cleansing of the lids with wipes, foams or washes specifically made for eyelids
    • Warm compresses are best performed with eye masks which can be placed in the microwave and applied to the eyes for 5-15 minutes daily
    • Avoid using baby shampoo as was once recommended as we now know it can be more drying and cause damage over time
    • Making sure to remove all makeup daily especially before going to sleep
** Avoid eye lash extensions, lash perms, tinting as these procedures cause additional damage
  • If you do get these cosmetic procedures, you should take extra care with daily hygiene
  • Avoid waterproof makeup, applying makeup directly to waterline, and permanent makeup like tattoo eyeliner

In office Meibomian gland expression

  • Gentle to moderate pressure is applied to the eyelids in order to express the glands – this is both diagnostic as we see what comes out of the gland, and therapeutic to help open up blocked glands and encourage healthier production
  • Ideally, a clearish olive oil like substance should easily come out of the gland when gentle pressure is applied. With blepharitis we instead we see cloudy, rigid or complete lack of oil coming out

Antibiotics

  • Drops, ointments and sometimes oral antibiotics may be prescribed depending on the severity of the condition

IPL

  • One of the best options for targeting and treating all causes of blepharitis and dry eyes.
  • This novel technology works to reduce inflammation in and around the eye, help the eye make healthier tears, reduces bacteria and Demodex load, and improves the quality of the Meibomian glands and the oil they produce