What Is Blepharitis?
Blepharitis
Blepharitis is the medical term describing inflammation of the eyelids. Blepharitis is very common. Many people with dry eye also have blepharitis which makes their dryness worse. Inflammation of the eyelids blocks the natural oil glands located in the margins of the eyelids. When these oil glands are blocked the tear film loses its oil layer. Without an oil layer the tears evaporate off your eyes and your dryness becomes worse. Blepharitis is a chronic condition that requires ongoing care to improve.
People with Acne Rosacea or Eczema are particularly at risk for blepharitis and dry eye. Treating these conditions may improve your dry eye.
Instructions for everyone with Blepharitis
- Wash your hands before touching around your eyes.
- Try to abstain from make-up especially during flare ups. If you do have to use make-up then apply to the front of the upper lashes only and not onto the lower lashes.
- Do NOT use facial lotions or moisturizing creams as these can worsen blepharitis when they get on the eyelids. Consider switching to Baby Johnson’s shampoo and washing your hair and entire face with this.
Lid scrub instructions:
Use lid scrubs once a week. Consider daily use only if you wear make-up that requires removal. “Lid-Care” or systane Lid Wipes are recommended as they are specially formulated so that it doesn’t irritate the eye. Open the towlette and make a lather. Use one side on one eye then turn it over and use the other side on the other eye. Apply the towlette so that you wash the edge of the eyelids that sits almost against the eye. If “Lid-Care” is not available then Baby Johnson’s shampoo may be used as an alternative. Massage all 4 eyelids firmly to squeeze the oil out of the eyelid glands. Wash away the soapy residue with clean water.
Hot compresses:
Although time consuming, if done properly this is one of the most effective treatments for blepharitis and dry eye! Lid compresses should be done once a day for a full 5 minutes. The hot compress should be very warm (40 degrees Celsius). This is warm enough to get the oil moving in your eyelids but not so warm that you burn your skin. You should press on all 4 eyelids after the hot compress to move the warmed oil. There are three methods for doing a warm compress. Choose the method that works best for you.
Run a hot water tap and use a hand towel to apply the wet heat directly to the closed eyelids. The hot towel should be touching the eyelids. When it cools down place the towel under the hot water and repeat until you’ve had a full 5 minute treatment.
The warm wet towel can be incorporated into your daily routine. Spend an extra 5 minutes in the shower. Step aside from the shower stream, turn the heat up and use a hand towel to apply the wet heat directly to the closed eyelids.
Do not wear contact lenses when your eyelids are inflamed or when you have dry eye. A chalazion, commonly referred to as stye, develops because of complete blockage of one of the eyelid glands. If you have a chalazion then you have underlying blepharitis. You should then do compresses even 2 to 3 times daily. Massaging the chalazion will also help push the oil through and may open up the blocked gland. If the chalazion doesn’t resolve after several months then your ophthalmologist may need to drain it surgically.
When medications are necessary, they may include:
artificial tears (over-the-counter eyedrops) to relieve symptoms of dry eye;
topical antibiotics to decrease bacteria on the eyelids;
steroids (short-term), to decrease inflammation; and
oral medication like tetracycline to thin oily secretions and prevent gland blockage.
Medications alone are not sufficient to control lid margin disease; the application of warmth and detailed cleansing of the lashes daily are both essential.