Causes for Blepharitis

• Anterior blepharitis is a bacterial infection or caused by dandruff of the scalp and eyebrows. These bacteria are commonly found on the face and eyelids, but when excess growth of these bacteria on the lid area reacts poorly to their presence, an infection may occur. In rare cases, it is also caused by allergies or a mite infestation of the eyelashes.
  
  
• Posterior blepharitis can occur due to a blocked oil gland on your eyelid. When the glands of the eyelids produce irregular oil, it creates a favorable environment for bacterial growth. Posterior blepharitis can also develop as a result of other skin conditions, such as rosacea. Posterior blepharitis is much more common than anterior blepharitis.
  
  

How is Blepharitis diagnosed?

Blepharitis is diagnosed through comprehensive eye testing, with special emphasis on the eyelids and front surface of the eyeball. Special test includes:

• Patient history:
  To determine any symptoms the patient is experiencing and the presence of any general health problems, medications taken, aging eyes, and/or diabetic eye problems, or any environmental factors that may be contributing to the eye problem.
  
  
• Examining your eye/eyelids:
  Your doctor will carefully examine your eye, including lid structure, skin texture and eyelash appearance. He or she may use a special magnifying instrument during the examination.
  
  
• Evaluation of the eyelids:
  Evaluation of the lid margins, base of the eyelashes and meibomian gland openings using bright light and magnification.
  
  
• Evaluation of the tears:
  Checking for abnormalities by evaluating the quantity and quality of tears.
  
  
• Swabbing skin for testing:
  For some severe cases, doctor may use a swab to collect a sample of the oil or crust that forms on your eyelid. This sample will be then analyzed for bacteria, fungi or evidence of an allergy.
  
  

Types of Blepharitis

It can be determined based on the appearance of the eyelid margins.

1. If the symptoms frequently exhibited by the patient are mild sticking eyelids, thickened lid margins, and missing/misdirected eyelashes, then patient is having Staphylococcal blepharitis.
   
   
2. If the patients have greasy flakes or scales around the base of eyelashes and a mild redness of the eyelids then it is Seborrheic blepharitis.
   
   
3. When the patient is found with blockage of the oil glands in the eyelids, poor quality of tears, and redness of the lining of the eyelids, then patient is having Meibomian blepharitis.
   
   
4. If a hard, matted crust is formed on the eyelashes, and while removing these some small sores are formed on the eyelashes that ooze and bleed, it is called Ulcerative blepharitis. Patients may also experience distortion of the front edges of the eyelids, loss of eyelash, and constant tearing. In severe conditions, the cornea which covers the eyeball is inflamed.
   
   

Treatment for Blepharitis

Blepharitis is a long-term (chronic) condition. Most people experience repeated episodes, separated by periods with no symptoms. Treatment depends on the type of blepharitis. It is important to keep the eyelids clean and free of crusts in both forms of blepharitis.

Your doctor may suggest prescription treatments in some cases:

• Medications to fight infection
• Medications to control inflammation
• Oily tear drops
• Artificial tears and steroid or antibiotic eyedrops.

People with blepharitis might find the following helpful:

• Applying warm compresses can loosen the crusts and reduce inflammation. Then gently scrub the eyelids with a washcloth moistened with warm water.
  
  
• Clean your eyelids once or twice daily and keep it without crust.
  
  
• If the glands in the eyelids are blocked, lightly massage the eyelids to clean out accumulated oil
  
  
• Make a solution of half baby shampoo or mild soap, half water. Place the cloth over your index finger or use cotton swab, dip it in the mix, and use it to clean your eyelid. Then wash the eyelids and eyelashes using warm water.
  
  
• Use anti-dandruff shampoo on the scalp if dandruff is present on the scalp or anti-bacterial shampoo to control mites.
  
  
• Use artificial tear solutions or lubricating ointments, if prescribed.
  
  
• Limit or stop using eye makeup during treatment, as it makes lid hygiene more difficult.
  
  
• Temporarily discontinue wearing contact lenses during treatment.