Blepharitis

What is Blepharitis?

Blepharitis is an inflammatory disorder that affects the eyelid margins. The inflammatory process can frequently affect the ocular surface and may cause dry eye disease. In most cases, it is a chronic condition that can be controlled with medical treatment. Although most patients’ have similar symptoms, there are different types of blepharitis and different causes.

What factors increase the chance of developing Blepharitis?

There are different causes for blepharitis and the condition is usually multifactorial. However, there are specific factors that can make it more common. Between 20 to 40% of patients with blepharitis suffer from associated dermatologic conditions such as rosacea and seborrheic dermatitis. Blepharitis can also be caused by infectious agents such as bacteria that normally live on our skin, and even parasites. Up to 30% of patients with blepharitis are found to have eyelash infestation by a mite known as Demodex. It is believed that the mite’s waste triggers inflammation on the eyelid margins and ocular surface, causing blepharitis and dry eyes. Although Demodex can be found in many asymptomatic patients, those who have blepharitis usually respond well to eradication of the mites through medical treatment.

What are the symptoms?

How is it diagnosed?

Blepharitis is easily diagnosed based on the patient’s clinical history and examination under magnification.

How is it treated?

In most cases, blepharitis is a chronic condition, and treatments are focused on controlling, rather than curing the disease. For the most part, initial treatment consists of a self-performed process called Eyelid Hygiene, which works by heating, softening, and removing the surface debris from the eyelashes and lid margins. Then the eyelids are massaged to expel accumulated thickened meibum. Recalcitrant cases may need oral or topical antibiotics, and sometimes topical corticosteroids. Severe cases may require in-office eyelid hygiene. This procedure is done with a mild local anesthetic gel. After heating the eyelids with a special device, the meibomian glands are carefully pressed until all the accumulated abnormal meibum is removed. This is followed by microblepharoexfoliation of the eyelid margins and lashes with a specially designed burr, and in some cases where there is infestation by Demodex mites, a highly concentrated solution of Tea Tree oil is applied to kill the parasites