What is blepharitis?
Blepharitis is inflammation of the edge of the eyelid and can be anterior (affecting the outermost area around the base of the eyelashes) or posterior (affecting the innermost part in contact with the eye), as well as mixed (a combination of anterior and posterior blepharitis). In the various cases, it may be associated with skin disorders, such as rosacea, seborrhoeic dermatitis and psoriasis, although it is not always possible to identify its cause.
It is a common problem that affects around 30% of the population and is often related to cases of dry eye, as it leads to a worsening of tear quality.
What causes it?
Anterior blepharitis is usually caused by excess oil or a proliferation of bacteria. In some cases, it is a consequence of infections caused by a microorganism called Demodex.
Posterior blepharitis is caused by a malfunction of the Meibomian glands, either due to them becoming blocked, damaged or producing too much oil secretion. These small glands are located inside the eyelids and are responsible for producing the lipid-based component of tears (the oil that makes them more stable and ensures that they stay on the ocular surface for an appropriate amount of time).
Meibomian gland dysfunction results in instability of the tear film, as well as inflammation and damage to the ocular surface. In general, it is a significant but overlooked condition, estimated to be present in about 85% of patients with ocular dryness. It is usually a result of:
- Excessive contact lens use
- Hormonal changes (adolescence and menopause)
- Treatments for skin diseases
How can it be prevented?
Careful and regular eyelid hygiene – in the same way that we brush our teeth every day – helps to eliminate excess bacteria and oil from the edges of the eyelids, thereby decreasing the likelihood of suffering from this condition. Find out detailed information on the steps to follow in our eye health tips section.
The degree of severity is extremely variable and, while milder cases can go unnoticed by patients or cause only discrete discomfort, the most serious ones can produce complications, mainly in the cornea, and even affect vision.
The following are some of the characteristic symptoms associated with blepharitis and Meibomian gland dysfunction:
- Redness of the eye
- Foreign body sensation
- Skin flakes between the eyelashes
- Ocular dryness
- Excessive need to blink
- Blurred vision
Clinical signs are often detected by the ophthalmologist before the patient notices any symptoms, which can manifest themselves late.
Blepharitis treatment is based on adequate daily eyelid hygiene carried out regularly and correctly to achieve good results. This requires applying warm swabs to closed eyelids for 5 minutes, massaging them vertically (towards the root of the eyelashes) to enable bacteria and oil to escape and, lastly, cleaning them with a soap solution or special wipes.
In some cases of blepharitis, topical treatment with antibiotic and/or anti-inflammatory eye drops may be required and, in addition, for some patients, certain treatments can be applied in the consulting room to improve the disorder and associated dry eye problems: