Blepharitis is a chronic condition where there is recurrent inflammation of the eyelid margin. The lids may look red and raw, and crust clings to the eyelashes. Blepharitis can be aggravated by smoky, dry or dusty atmospheres. The most common and least severe form is seborrheic blepharitis, which is often associated with dandruff of the scalp or skin conditions like acne. It usually appears as greasy flakes or scales around the base of the eyelashes and as a mild redness of the eyelids. This condition frequently occurs in people who have oily skin, dandruff, or dry eyes. Another form of blepharitis can be associated with infection of the eyelids. Blepharitis can begin in early childhood although it is more commonly a problem that develops later in life. An important concept is the fact that blepharitis is a chronic condition. Once it is present, it will always be present, but the severity may change over time. In some cases, the symptoms can disappear for long time periods, months or years before returning. Blepharitis is not contagious and cannot be passed from one person to another.

What causes Blepharitis?

The most common causes of blepharitis are poor eyelid hygiene and excess oil produced by skin around the eyelids. Bacterial infections or allergic reactions can also exacerbate this condition. Blepharitis can be caused by the bacteria which live on our skin. In some cases, these bacteria are "nourished" by the secretions of the oil glands in our eyelids .In other patients, there is an inability to fight off these bacteria adequately.

Symptoms

Blepharitis is characterized by redness of the eyelid margin and crusty scales or flaking around the eyelashes. These crusty discharges are greasy in nature. The eyelids may be sticky or glued shut in the morning. There may be itching, burning or irritation on the lid margins. The eyes may sometimes feel dry and irritated. Sties and chalazia may also occur.

Treatment

The inflammation around the eyelids can be improved by increased lid hygiene. Gently scrubbing the eyelid margins with baby shampoo diluted with water can decrease the amount of flaking skin and oil in the area. This treatment must be carried out on a daily basis while the problem is active. Some patients do not respond adequately to lid hygiene. In these patients, antibiotic drops may be required. Blepharitis can be chronic and recurrent. It can be controlled, but there will be better and worse periods. Daily attention may be needed to suppress the symptoms.

Lid scrubs can be performed as follows:

Apply a warm, moist washcloth, redipping in warm water as necessary to keep heat constant for two minutes to each affected eye. Pour a few drops of tearless baby shampoo into a clean container {"shot" glass for instance). Add warm water (about 1/2 ounce) to make a dilute soapy solution. Dip a cotton swab into the solution and gently massage the outside of the eyelid including the eyelashes with the cotton swab. You may use plain water and a cotton swab if the shampoo is irritating. Rinse the face to remove any residual shampoo. Perform the lid scrubs more frequently (twice a day) for the first month. Gradually reduce the lid scrubs to a frequency that keeps your eyes comfortable.

*alternatively EyeScrubs can be purchased from the pharmacy and used to clean the eyelids.