Healthy eyelids, healthy eyes... a guide to treating blepharitis

The word blepharitis is derived from the greek word ‘blepharos’ meaning eyelid and ‘-itis’ meaning inflammation. It is extremely common and usually harmless. It can cause irritation but is usually harmless in nature. It is usually divided into anterior and posterior blepharitis, however there can be a combination of both affecting the eyelid. The posterior form affects the ‘posterior lamella’ of the eyelid and in particular the meibomian glands. These are responsible for producing part of a healthy tear film. Without their secretions, the tear oil breaks up far too quickly and can lead to a dry eye. This is often the mechanism through which blepharitis causes discomfort.

The tear film is the most important refractive (focussing) surface of light in the eye. This is because of the change in ‘refractive index’ or focussing power going from air to water. Hence, a dry eye can contribute to blurry vision. Treating blepharitis will therefore help with stability of the tear film and as well as improving comfort, will help with symptoms of blurring.

The traditional treatment has been to use hot compresses on the eyelids massage the eyelids. This allows the meibomian gland secretions to be secreted and contribute to the tear film. Cleaning the margins of the eyelids helps remove the inflammatory debris by physically removing the material. Bacteria are thought to contribute to the problem so this will reduce the bacterial load. Cotton buds and diluted baby shampoo to clean along the lashes are usually recommended. More recently and conveniently, eyelid wipes have been made to do the same job. These can be purchased from most pharmacies or opticians. They are more convenient however should be equally effective.

If this treatment is not enough, there are further measures that can be taken. There may be underlying conditions that can contribute to blepharitis such as eczema or blepharitis. Treatments include topical steroid drops or an extended course of oral antibiotics. Treating these underlying conditions can help with managing blepharitis.