Blepharitis

Our eyelids help protect our eyes. (Read about "The Eye") Blepharitis is a common condition that causes inflammation of the eyelids. The American Optometric Association (AOA) says the four main causes are:

• excessive oil produced by the glands in the eyelid
• a bacterial infection - often staphylococcal (Read about "Microorganisms" "Staph and MRSA")
• an allergic reaction (Read about "Allergies")
• conditions such as rosacea or seborrheic dermatitis of the face and scalp (Read about "Rosacea and Rhinophyma" "Eczema and Dermatitis")

Blepharitis occurs in two forms, according to the National Eye Institute (NEI):

• Anterior blepharitis affects the outside front of the eyelid, where the eyelashes are attached. The two most common causes of anterior blepharitis are bacteria (Staphylococcus) and scalp dandruff.
• Posterior blepharitis affects the inner eyelid (the moist part that makes contact with the eye) and is caused by problems with the oil (meibomian) glands in this part of the eyelid. Two skin disorders can cause this form of blepharitis: acne rosacea, which leads to red and inflamed skin, and seborrheic dermatitis. (Read about "Skin" "Eczema and Dermatitis")

Symptoms and complications

Symptoms of blepharitis include a foreign body or burning sensation, excessive tearing, itching, sensitivity to light (photophobia), red and swollen eyelids, redness of the eye, blurred vision, frothy tears, dry eye or crusting of the eyelashes on awakening.

NEI says that complications from blepharitis include:

• Stye - A red tender bump on the eyelid that is caused by an acute infection of the oil glands of the eyelid.
• Chalazion - This condition can follow the development of a stye. It is a usually painless firm lump caused by inflammation of the oil glands of the eyelid. Chalazion can be painful and red if there is also an infection.
• Problems with the tear film - Abnormal or decreased oil secretions that are part of the tear film can result in excess tearing or dry eye. (Read about "Dry Eye") Because tears are necessary to keep the cornea healthy, tear film problems can make people more at risk for corneal infections.

Treatment

AOA says treatment for both forms of blepharitis involves keeping the lids clean and free of crusts. According to AOA, warm compresses should be applied to the lid to loosen the crusts, followed by a light scrubbing of the eyelid with a cotton swab and a mixture of water and baby shampoo. Because blepharitis rarely goes away completely, most patients must maintain an eyelid hygiene routine for life. If the blepharitis is severe, an eye care professional may also prescribe antibiotics (Read about "Antibiotics") or steroid eye drops, according to NEI.

When seborrheic dermatitis is present, a dandruff shampoo for the hair is recommended as well. (Read about "Eczema and Dermatitis") In addition to the warm compresses, patients with posterior blepharitis will need to massage their eyelids to clean the oil accumulated in the glands, according to AOA. Patients who also have the skin condition rosacea may need to have that condition treated at the same time.