Blepharitis

Blepharitis
by David C. Gritz, MD, MPH

Blepharitis is a very common problem. It is characterized by a chronic infection and inflammation of the eyelids that irritates the eyes. Typically, it is not a vision threatening problem, but can be very bothersome. Symptoms can include redness, burning, dry feelings, tearing, sandy-gritty sensations, feelings that there is something in the eye, and many other symptoms caused by the irritation to the surface of the eye. The problem is chronic and cannot be cured but can be controlled through diligent maintenance treatment by the patient.

There are different variations of blepharitis. Your treatment will be tailored by your doctor according to your needs.

The treatment and control of blepharitis has a step-wise approach to keeping the eyelids clean. Cleaning the dirt and debris from the lids and lashes and reducing the bacteria from this area will improve in symptoms. The basic steps are outlined below. You can tailor these basic steps according to how much your symptoms improve or worsen. Blepharitis typically has a life-long, fluctuating, up and down course. Depending on the severity of your symptoms at the time, you may need either aggressive treatment or may be able to relax on your routine.

The goal is to clean the eyelids without being too aggressive. Being too aggressive can cause more eyelid irritation.

The most basic treatment is WARM COMPRESSES. While doing your normal morning and bedtime routine, run very hot water over a washcloth and wring the washcloth out. Hold the washcloth over the closed eyes. You can gently massage the eyes during this time. When the washcloth cools off, repeat the process. A good starting point for treatment is to do this twice in the morning and twice at bedtime. This can be repeated as many times as you like, if you feel that it is helping. Tailor you treatment to clean the eyelids, not irritate them.

Following the warm compresses, Johnson’s BABY SHAMPOO can be used to clean the eyelids. Dilute the shampoo with some water. Gently clean the eyelids using one of the following: fingertips, a washcloth, cotton pads or cotton balls. (Patients should find the choice is best for their eyes.) Keep the eyelids closed and wash along the edges of the eyelids. Rinse the soap when finished. Name brand Johnsons’ Baby Shampoo is recommended because it is very gentle and least likely to cause irritation. Cleaning with baby shampoo can be performed once or twice a day, depending on the severity of your symptoms.

Your symptoms likely will not improve immediately. In fact they may initially worsen slightly. You should stay diligent, however, because the improvement will only take place over a period of weeks and continue over weeks or months. If you don’t do the treatment, it won’t help. Long term treatment is needed to control this chronic problem.

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