Blepharitis Treatment Arizona.
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Chronic Eyelid Inflammation
Blepharitis is one of the most common disorders
of the eye and is often the underlying reason for eye discomfort. It
is characterized by inflammation of the eyelid margins and
usually causes redness of the eyes, along with itching and irritation
of the eyelids, typically in both eyes. The appearance of blepharitis
is often confused with conjunctivitis and due to its recurring nature,
it is the most common cause of "recurrent
conjunctivitis" in older people. Because of the gritty sensation
associated with blepharitis, many patients think they have "dry
although lubricating drops do little to improve the condition.
Causes of Blepharitis
· Excessive oil produced by the glands in the eyelid
· Bacterial infection, often staphylococcal
· Allergic reactions
· Inadequate eyelid hygiene
Everyone has bacteria on the surface of their skin, but in some people, bacteria
especially thrive in the skin at the base of the eyelashes. Excessive amounts
of bacteria around the eyelashes and eyelid margins can cause dandruff-like
scales and particles to form. Blepharitis is also associated with meibomitis
- dysfunction and inflammation of the nearby oil glands of the eyelids (called
meibomian glands). When functioning normally, these glands secrete a thin
oily coating into the natural tear film that helps to prevent rapid evaporation
and therefore helps keep the eyes moist.
Symptoms of Blepharitis
| · Itchy, burning eyes
· Watery eyes
· Sore eyes
· Redness of eyelid edges
· Light sensitivity
· Dilated blood vessels
· Loss of lashes
· Blurred vision
· Inflamed cornea
· Sticky discharge along lash line
· Crusting or greasy, waxy scales
· Frequent stye formation
· Distortion of front edges of eyelids
· Chalazia (nodules on eyelids)
· Tiny pimples on eyelid edges
· Scaly flakes along eyelid margins
· Gritty, irritating sensation
· Symptoms most noticeable upon awakening
Forms of Blepharitis
Blepharitis is chronic in nature, meaning it exists as an ongoing
condition There are two forms of blepharitis, depending upon location:
Anterior Blepharitis and Posterior Blepharitis.
· Anterior Blepharitis
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 (seborrhea).
Staphylococcus Blepharitis (bacterial infection)
Staphylococcus blepharitis is a contagious
form, caused by a germ called staphylococci, commonly known as staph.
It often is contracted in childhood and continues throughout adulthood.
On average, patients with staphylococcal blepharitis are relatively young
with a short history of ocular symptoms.
Seborrhea Blepharitis (dandruff)
Seborrhea blepharitis is the most common and least severe form of blepharitis.
Patients are generally older and have a long history of ocular symptoms. Seborrhea
blepharitis is not an infection, but is caused by improper function of the
oil glands, causing greasy, waxy scales to accumulate along the eyelid margins.
Seborrhea blepharitis may be a part of an overall skin disorder that affects
other areas of the body. Hormones, nutrition, general physical condition and
stress are factors in seborrhea. Patients usually have seborrhea dermatitis
(dandruff of the scalp) as well.
Symptoms of seborrhea blepharitis include any of
the following: scales, matted, hard crusts around the lashes, crusting (that
make opening the eyes in the morning difficult), chronic redness at the lid
margin, dilated blood vessels, loss of lashes, sties, and chalazion (pronounced
chuh-LAY-zee-un) - an enlarged lump caused by clogged oil secretions in the
· Posterior Blepharitis
Posterior blepharitis affects
the inner eyelid (the moist part that makes contact with the eye) and is caused
by meibomian gland dysfunction (problems with the oil glands in
this part of the eyelid). Two skin disorders that cause posterior blepharitis
red and inflamed skin) and seborrheic dermatitis (scalp dandruff).
Meibomian gland openings are plugged with oily secretions.
Notice also prominent blood vessels on eyelid margin.
· Meibomian Gland Dysfunction (MGD)
The meibomian glands
are oil glands embedded in upper and lower eyelids. They produce
an oily secretion that forms an important part of normal tear film. Dysfunction
of the meibomian glands produces excessive oily secretions. The tear film
may then become unstable and result in a 'dry eye' as well as chronic red
irritated eyes. Patients are generally older and have a long history of ocular
symptoms. Symptoms include prominent blood vessels crossing the eyelid margin
and plugging of gland openings, which results in the inability to secrete
oil properly and/or thick oily secretions.
Treatments of Blepharitis
Treatment is usually ongoing and sometimes frustrating, depending on the type
of blepharitis you have. Expect to keep up therapy for a prolonged period of
time to keep it at bay. Treatment may include:
In addition to alleviating the redness and soreness, proper treatment may
prevent future infection and scarring of the cornea. A complete eye examination
by an ophthalmologist is essential.
· Warm compresses for blepharitis
Warm compresses have been shown to be effective in treatment of
all kinds of blepharitis. These
compresses soften the debris and crust on the lid margin
so that they are more easily removed. Warm compresses may be combined with
eyelid massage. This is especially important in patients who have meibomian
gland dysfunction (MGD).
Wash your hands, then dampen a clean washcloth with very warm water, wring
it out and place it over your closed eyes for at least one minute. Repeat two
or three times, wetting the washcloth again with warm water as it cools. This
will loosen the scale and debris around your eyelashes. It also helps dilute
oil secretions from nearby oil glands, preventing the development of chalazion
(pronounced chuh-LAY-zee-un) - an enlarged lump caused by clogged oil secretions
in the eyelid. An alternative variation involves adjusting the shower so that
it is a very gentle stream of very warm (but comfortable!) water that is allowed
to flow over the gently closed eyelids for about 1 or 2 minutes.
When you first begin treatment, do this four times a day, for at least five
minutes each time. Later on, you might apply the compress once a day, for a
few minutes. Your doctor will tell you the specific treatment needed for
· Meticulous cleansing for blepharitis
Cleansing the eyelids is essential to blepharitis treatment. your eye doctor
will recommend what to clean them with: warm water only, baby shampoo
diluted with warm water or a special product made for cleansing the lids.
First, wash your hands, then dip a clean washcloth (typically draped over your
index finger for control), cotton swab, gauze pad, or commercial lint-free pad
into your cleaning solution. Gently wipe it across your lashes and lid margin
for about 15 seconds per eyelid. Use a magnifying mirror if necessary to avoid
accidentally rubbing the eyeball itself. Rinse with cool water. When you first
begin treatment, your doctor may have you cleanse your lids several times a day.
Later on, you will probably cleanse them about once a day.
Because blepharitis can be a persistent problem, you should practice
good skin and eyelid hygiene to prevent recurrences. In addition to careful
cleansing of your eyelashes, washing your hair, scalp and eyebrows with
antibacterial shampoo can also help control blepharitis.
· Medication for blepharitis
In some cases, it is necessary to use prescribed eye drops, ointment or oral
medication along with the daily cleansing regimen. Be careful to follow recommended
dosages. And with any medication, there is a small possibility of allergy or
other reaction, including skin rash, slight nausea and increased sensitivity
Antibiotic ointment should be applied using a clean fingertip or cotton swab;
gently apply a small amount at the base of the eyelashes before bedtime.
Artificial tears or steroid eye drops may also be prescribed temporarily
to relieve dry eye or inflammation. Although medications may help control the
symptoms of blepharitis, they alone are not sufficient; keeping the eyelids
clean to reduce bacterial count is essential.
· Massaging for blepharitis
If you have meibomian gland dysfunction (MGB), your ophthalmologist will
probably recommend massaging the lids to remove excess oil. Do not use this
technique unless specifically recommended after a careful
In MGD, the meibomian (oil) secretions are thick and the gland openings are
clogged. Think of a toothpaste tube that contains butter instead of toothpaste.
When cold, you would not be able to squeeze the butter out of the tube. However,
once you warm it a bit, then the butter will soften enough to come out of the
tube, but some pressure on the tube (squeezing) would still be necessary.
Going by this analogy, after you have applied warm compresses, the thick
oils in your lids will be more fluid, but a particular type of massage will
be necessary to express them. Therefore after every minute of warm compresses,
massage the eyelids as follows:
Gently close your eyelids. Put your index finger on the outer corner
of the eyelid. Pull the eyelid towards the ear, so that the eyelids are stretched
taut. Next use the index finger of the opposite hand to apply direct pressure
to the taut eyelids starting at the inner aspect of the eyelid near the base
of the nose. Sweep with firm but gentle pressure towards the ear. Repeat this
maneuver four to five times. The goal is to apply gentle pressure to the eyelids
as if you were squeezing a tiny tube of toothpaste - just rubbing the eyelid
surface will not be nearly as productive.
Blepharitis Treatment Arizona.
The eye specialists of East Valley Ophthalmology perform advanced
technology diagnostic testing and treatment, as well as taking
the time necessary to provide each patient with information needed
to fully understand their condition and to achieve their best possible
If you would like further information, please call our office at:
East Valley Ophthalmology
Eye Doctors - Mesa, Arizona
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