Blepharitis

  • Blepharitis is the name given to inflammation of the eyelids. 

  • It comes in a number of forms, and it has a wide variety of causes.

  • It can cause symptoms such as dryness, wateriness, redness, irritation, burning, itchiness, stinging and grittiness. It can change the appearance of the lids, making them look red or swollen or the lid margin uneven. Flaky skin and discharge can collect around the base of the eye lashes, and the eyelashes can change pigmentation or disappear.

  • Blepharitis can be present for a short amount of time, it can occur episodically, or it can linger for many years.

  • Treatment and management of one’s blepharitis is individual to the case, and may need to vary over time. If you believe you have blepharitis, it is very important that we do a full examination of your eye and eyelid health to determine the best course of treatment for you.

  • Call us now on 08 7225 9798 or email bookings@alleveeyeclinic.com.au.

  • Anterior Blepharitis

  • Anterior blepharitis is inflammation along the front of the eyelid, typically along the base of the eyelashes.

  • It can make the eyes and eyelids feel dry, scratchy, burning and gritty. A dandruff-like material on the eyelashes is frequently seen, and the lids can often be red. Chronic anterior blepharitis can cause eyelashes to bleach, change growth direction, or even fall out.

  • It can more commonly affect middle-aged women and those in warmer climates and it can also cause styes or chalazions (infected oil glands)

  • Symptoms are often worse in the morning due to the collection of inflammatory molecules that get trapped in the tear film overnight.

  • A common cause is overgrowth of the normal skin bacteria, such as staphylcoccus aureus or s. epidermidis. This can cause a golden crusting or scaling on the lids and mild inflammation.

  • Another cause is seborrheic dermatits– this causes redness and flaking of the skin and a greasy, scaly dandruff-like material on the lashes. Lid cleaning and treatment with anti-seborrheic preparations is helpful, and use of anti-dandruff shampoo for the scalp can be helpful.

  • A third cause but less common is Angular Blepharitis where there is crusting and inflammation at the edges of the outer eyelids. This too responds well to cleaning and antibiotic treatments.

  • Fundamentally, treatment is to reduce the food supply of the skin bacteria and to reduce the microbial load of the skin. In other words, cleaning the skin around the lashes and on the lid margin. Preparations such SteriLid and Systane Lid Wipes can be used to clean the lids of the bacteria and debris.

  • Resistant cases may need a course of antibiotic ointment or tablets to treat it, or topical steroids to quieten down the inflammation.

Posterior Blepharitis

  • Posterior Blepharitis is an inflammation of the back edge of the eyelid margin.

  • It affects the Meibomian glands, the large and important oil producing glands that open just behind the eye lashes, and it irritates the skin around them and the eye surface next to them. Meibomian Gland Dysfunction and Meibomianitis typically cause posterior blepharitis.

  • Posterior blepharitis causes the oil glands to function very poorly. The glands can fail to release oil onto the tear film, and lack of this oil is responsible for 80% of dry eye cases. Without this oil, or with low quality oil, a poor quality tear film results, leading to symptoms of dryness, watering, burning, stinging and red eyes.

  • The lid margin and inner lid surface is typically red and inflamed, often with eye surface involvement. The oil glands are often plugged with a waxy cap or ‘cork’, and this exacerbates the inflammation by preventing the glands from releasing their oil. This may lead to loss or shortening of the glands, or a chalazion (a cyst) to develop within the eye lid.

  • Causes of posterior blepharitis can range from ageing to acne roseacea, medications, environmental conditions such as wind and air conditioners, arthritis, hormone changes, and many other factors. There can be a hereditary influence with some skin types being more susceptible.

  • Symptoms can be made worse by reading, computer use, driving and television watching, as the poor tear film is not refreshed by blinking as frequently during these activities.

  • Diagnosis is made through a comprehensive history and examination of the tear film, tear ducts, eyelashes and oil glands

  • Primary treatment involves allowing the meibum (oil) in the glands to start flowing normally. treating the inflammation, softening the oil and expressing the blocked glands to allow the Meibomian glands to produce and release healthy, normal oil. Our clinic offers a variety of ways to manage the condition, which are tailored depending on the cause and the severity.

Demodex Blepharitis

  • A common cause of anterior and posterior blepharitis is the Demodex mite. This tiny arachnid is common to most of us, and the little critter can live either in the base of the eyelashes (demodex folliculorum) or in the glands themselves (demodex brevis). In most people it doesn't cause any problems, but in some people, particularly with an overabundance of the mite, it can cause significant inflammation.

  • Demodex blepharitis produces a cylindrical crusting at the base of the lashes along with the inflammation typical of posterior blepharitis. Disruption of the lashes can often reveal the mites clinging to the hair.

  • A very effective treatment is using the Blephex in-rooms treatment system. This gently and harmlessly cleans the lids and kills and removes the mites using natural tea tree oil and a mechanical brush.

  • Once the bulk of the mites and lid build-up is removed, an at-home treatment with a lid cleaner containing an ingredient that kills the mites can be used to keep the condition under control and symptom free. We recommend Blephadex which contains tea-tree oil as the active ingredient.

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Demodex Blepharitis

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