BLEPHARITIS

General Information

DEFINITION--Inflammation of the eyelid edges.

BODY PARTS INVOLVED--Eyelids; eyelashes; meibomian glands (those which lubricate the lid); conjunctiva (white of the eye).

SEX OR AGE MOST AFFECTED--Adults of both sexes.

SIGNS & SYMPTOMS

• Redness and greasy scales on the eyelid edges.
• Eyelashes that fall out.
• Small ulcers on the eyelid. If the lid edges ulcerate, crusts will form. If crusts are removed, lids will bleed.
• Irritation of the eye if flakes from the lid fall into the eye.
• A feeling that something is in the eye. This includes itching, burning, redness, swelling of the lid, sensitivity to bright light and tearing.
• Discharge from the lids, which glues lashes together during sleep.
• Sensitivity to light.

CAUSES

• Bacterial infection, usually staphylococcal, of the eyelash follicles and the meibomian glands.
• Allergic reaction (less serious inflammation only).
• Body lice (rare).

RISK INCREASES WITH

• Adults over 60.
• Medical history of seborrheic dermatitis of the scalp and other body parts.
• Exposure to chemical or environmental irritants.
• Crowded or unsanitary living conditions.
• Poor nutrition.
• Immunosuppression due to illness or medication.
• Diabetes mellitus.
• Acne rosacea.

HOW TO PREVENT

• Wash hands often and dry with clean towels.
• Avoid environments that contain dust or other irritating substances.
• Use hypoallergenic eye makeup.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory culture of the discharge from lids (sometimes).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment. If blepharitis is caused by lice, your doctor will remove them with tweezers or medication.

POSSIBLE COMPLICATIONS

• Loss of eyelashes.
• Ulceration of the cornea (covering of the eye).
• Scarred eyelids.
• Stye.
• Misdirected eyelash growth.

PROBABLE OUTCOME--Blepharitis is stubbornly resistant to treatment, but it is sometimes curable in 8 to 12 months. Recurrence is common.

How To Treat

GENERAL MEASURES--

• Use warm-water soaks (see Appendix) to reduce inflammation and hasten healing. Apply soaks for 20 minutes, then rest at least 1 hour. Repeat as often as needed.
• Remove scales from the lids each day.
• Don't wear eye makeup until inflammation subsides.
• Discontinue soft contact lenses until condition cleared.

MEDICATION--Your doctor may prescribe:

• Antibiotic ointment or eyedrops, which may contain cortisone drugs.
• Oral medication may be prescribed in severe cases such as with acne rosacea.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of blepharitis.
• You have pain in the eye.
• Your vision changes.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.