What Is Blepharitis
- It is common and not usually vision threatening
- It is inflammation of the eyelids, sometimes combined with blockage of the meibomian glands.
- Affects upper and lower eyelid margins, usually on both sides
- May be associated with other skin conditions such as acne rosacea or dermatitis
- Treatment can take 3-6 weeks to be effective
- Needs long term regular daily or twice daily treatment to control symptoms
- Itchy, dry or watery eyes
- Red eyes, sometimes sore eyelid margins
- Feeling of “something in the eye”
- Sticky eyelids or lashes often in the mornings
- Intolerance of contact lenses
- Recurrent styes or chalazia
- Hot compresses
- Eyelid massage: eyelid gland massage/expression
- Cleaning of eyelid margins
Hold a comfortably hot wet face washer or flannel against the closed eyelids for 2 to 5 minutes. This melts the oils in the blocked meibomian glands.
Using a clean, dry cotton tip aligned horizontally. Firmly compress the skin of the lids just above the upper lid margin lashes and below the lower lid margin lashes. This helps unblock the meibomian glands by squeezing them and expresses the oils onto the eye where they can improve the quality of the tear film.
Clean away any crusts on the eyelid margins (edges) particularly around the roots of the eye lashes using fresh cotton buds dipped in either one of the following:
- cooled, boiled water only (recommended)
- preservative free eye drops (e.g. Bion Tears or Theratears etc)
- sodium bicarbonate solution*
- diluted baby shampoo*
- commercially available wipes or solutions e.g. Sterilid (Theratears) can be of some use for patients, but “Lid Care” (Novartis) is not sufficient on its own for posterior blepharitis.
- Do not dip a used cotton bud into your cleaning solution
- Do not clean inside the eye lids or touch the eye itself
- Always use fresh cotton buds for each eye.
SODIUM BICARBONATE SOLUTION (not recommended for sensitive skin)
1. Boil 600ml (1 pint) of water and let it cool
2. Add 1 teaspoon of bicarbonate of soda (or ¼ teaspoon in 1 cup cool boiled water) Mix thoroughly
3. Prepare a fresh solution each day (or keep in a covered clean container in the refrigerator and prepare a fresh solution weekly)
DILUTE BABY SHAMPOO (not recommended for sensitive skin)
1. Boil a cup of water and let it cool
2. Add one to three drops of baby shampoo to the cup
3. Mix well
4. Prepare a fresh solution each day
Blepharitis and Dry Eyes often co-exist.
- Mild dry eye: use bottled lubricants as required: eg. Systane Balance, Systane Ultra,
Genteal, Refresh tears plus, Optive, Liquifilm tears, Polytears.
- Moderate dry eye: use lubricants at least 3-4 times a day. Consider preservative free drops.
- Severe dry eye: use preservative free drops such as Bion Tears, Theratears drops, Cellufresh, Blink, Optive Sensitive, or thicker drops such as Theratears liquid gel, Polygel, Celluvisc at least 4 times a day, in addition to a night time ointment such as Ircal or Lacrilube.
Other strategies for dry eyes:
- Wear wrap around sunglasses (or “onion goggles” or see www.fuglies.com.au, www.heavyglare.com ) to reduce wind and sun exposure, avoid air conditioning or dry heating.
- Consider if your oral medications are making your dry eyes worse.
- Also consider a humidifier for your home or office.
- Consider taking Omega 3 supplements eg Theratears nutrition tablets (fish oil and flax seed oils) three times per day. Keep adequately hydrated.
There may be other options to manage severe dry eyes if adequate comfort is not achieved. Dr Noni Lewis can advise you on these. Please contact our office to make an appointment if you would like better management of your eyes, or if you have any concerns.