Blepharitis is probably the most commonly diagnosed problem in the office of a general ophthalmologist, and is probably the most UNDERdiagnosed problem in the general population. Often, patients are seen in their primary care doctor’s office with typical complaints, which can be confused with several other common problems. When the patient does not respond to the initial treatment by their internist or family practitioner, they are often referred to an ophthalmologist for evaluation and treatment.
What is blepharitis?
Blepharitis is inflammation of the skin and glands in the eyelids. It tends to be chronic and recurrent, and can begin at any stage of life. It is unlikely to cause damage to the eyes, and is not considered a serious threat to vision. It is unusual for blepharitis to affect the eye itself. When the eye is affected, it is possible that damage to the cornea, which is the front surface of the eye, can occur.
What are the common symptoms of blepharitis?
Blepharitis can cause a variety of symptoms, and many of them overlap with other eye conditions such as allergies, conjunctivitis (such as pink eye), and contact lens intolerance. The most common symtoms are:
Itching is the most common complaint with this disease. It is usually present all day long, and this may help differentiate it from other causes of itching. For instance, contact lens intolerance will usually be worse at the end of the day, especially right after removal of the lenses.
- Redness and Swelling
Patients with blepharitis will often have redness and swelling of the skin of the eyelids, especially at the ‘lid margin’, which is where the eyelashes attach to the eyelid. This is because most of the inflammation is present right at the base of the eyelashes. It is unusual for blepharitis to cause redness of the eye itself, but in advanced or untreated blepharitis, this can be seen.
- Flakes or Granulation
Tiny flakes, that look like dandruff, tend to be found at the base of the eyelashes. There are several types of flakes, which can sometimes give an indication of the source of the blepharitis. Many patients will state that they have ‘granulated eyelids’, or will mention grittiness on the lids and lashes.
What are the common causes of blepharitis?
Blepharitis be caused by, or are related to, many different problems, such as allergies, skin conditions like exczema or psoriasis, as well as from the normal bacteria that we all have on our skin at all times. The most common bacteria are Staph and Strep. In general, it doesn’t matter which is the root of the problem; the treatment does not tend to vary much.
Treatment of blepharitis
Treatment is pretty simple, and consists of use of either dilute baby shampoo, or commercial solutions to cleanse the eyelids on a regular basis. Some patients need this treatment every day, some can use it every 2nd or 3rd day. Occasionally, antibiotic drops, steroid drops, or even oral antibiotics may be necessary. A full examination by your eye doctor will help you determine the proper course of treatment.