BLEPHARITIS

Blepharitis is a CHRONIC (ONGOING) inflammation of the eyelids. It usually affects the edges of the eyelids. It is not usually serious, but may become an uncomfortable, irritating problem. Both eyes are usually affected.

o The main symptom is sore eyelids and foreign body sensation in the eye (s)

o The eyes may feel gritty, itchy or as though they are burning

o The eyelids may look inflamed or greasy.

o The eyes may become sticky with discharge. In particular, the eyelids may stick together in the morning.

o Sometimes tiny flakes or scales appear on the eyelids, which look like small flakes of dandruff. Crusts may develop at the base of eyelashes.

o One or more of the tiny glands of the eyelids (meibomian glands) may block and fill with an oily fluid.

o Symptoms often come and go. Typically, symptoms flare up from time to time, but you may have long periods without any symptoms.

-Seborrheic dermatitis — dandruff of the scalp and eyebrows.

-Clogged or malfunctioning oil glands in your eyelids.

-Rosacea — a skin condition characterized by facial redness.

-Allergies, including allergic reactions to eye medications, contact lens solutions or eye makeup.

-Eyelash mites or lice.

-Hormone changes (more common in post menopausal women)

-Increased stress

There is no one-off cure for blepharitis, as the inflammation tends to recur if you do not keep up with treatment. However, with regular treatment, symptoms can usually be eased and then kept to a minimum. This helps to prevent flare-ups. The aim of treatment is to control or manage blepharitis, not to cure it. Most of the treatment is done by you, rather than having prescriptions or treatments from your doctor. 

o Daily warm compresses using a Bruder mask, bean bag, Tylenol bottle filled with hot water for 5-10 minutes

o Eyelid scrubs with mild baby shampoo to the base of the lashes 3-4 times per week

o Erythromycin or Tobradex ointment- apply in eye before bedtime

o Lotemax 1 drop TID x 3-4 weeks

o Minocycline 50mg once a day or Doxycyxline 100mg po twice per day or Apprilon 40mg once a day for one month

o Restasis or Xiidra 1 drop twice a day 

o Omega-3 supplements 1500-2000mg daily

o Artificial tears as needed- Preservative free (Hylo, Theoloz duo), or non Preservative (Systane, Refresh, Gen teal etc) 

For demodex: Tea tree oil 5% (Claridex off internet) - apply to eyelashes twice a day morning and night