What is Blepharitis?
Blepharitis is a common lid problem. Inflammation of the lid margin and overgrowth of bacteria are commonly present. Scales can form around the base of the lashes. Often the oil glands do not function properly. The oily secretions of these glands can become thickened, the gland openings can become blocked, and the glands become inflamed. These conditions can lead to irritation and redness of the eyes and lids, conjunctivitis and corneal infections. This is a chronic condition that is not eradicated by treatment. Continual treatment is necessary to keep it under control. Some people will have flare-ups of inflammation in spite of regular treatment.

How Do You Treat Blepharitis?
The main treatment of blepharitis is lid hygiene. Cleansing of the lid margins removes excess oil and scales and reduces bacteria. Antibiotic ointment and oral antibiotics may also be of benefit.

How to Perform Lid Hygiene:
You will need
  1. A washcloth soaked in warm water.
  2. A mild detergent that will not irritate the eye.
  3. Something to apply the detergent.
Detergents For Lid Cleansing:
The best detergents are those that are specifically made for this purpose. Commercially available lid cleansing detergents include:
  • OCUCLENZ
  • EV Lid Cleanser
  • ocuSOFT Lid Scrub
If you cannot find one of these detergents, or another commercial lid cleansing detergent, your pharmacist may be able to order one for you. You can also prepare your own lid detergent from baby shampoo. It is not quite as effective and can be more irritating than the commercial detergents. Dilute the shampoo by using 2 parts warm water to one part shampoo.

Applicating Material:
  • a cotton ball
  • small (1 inch square or 2 inch square) gauze pad
  • the edge of a washcloth
Technique:
PERFORM ONLY THE STEPS CHECKED FOR YOU.
  1. Soak a washcloth with warm water. Wring it out and apply it over your closed eyelids for 5 minutes. It may be necessary to re-wet the washcloth to keep it warm.
  2. Massage the lid margins to express excess oil from the oil glands.
  3. Apply detergent to the applicator and, with the eye closed, scrub the base of the lashes with a horizontal back and forth motion for thirty seconds. Then, open the eye and, while looking upward, scrub the base of the lashes of the lower lid for thirty seconds. Avoid rubbing the eye itself, but it is okay to get detergent in the eye. Repeat for the second eye.
  4. Thoroughly rinse your eyes with cool tap water and dry gently with a clean towel.
  5. Apply antibiotic ointment to the base of the lashes with your finger or a cotton swab.
This regimen should be performed twice daily for one month and then once daily. Most people need to continue daily lid hygiene indefinitely. In some cases the frequency can be reduced to 3 times weekly. In others, lid hygiene can be discontinued after several months.

Oral Antibiotics
In some cases oral antibiotics are also used. The most commonly used antibiotics are tetracycline and doxycycline. They must be taken on an empty stomach (at least 1 hour before eating or 2 hours after eating). They can be associated with upset stomach or diarrhea. Sensitivity to sunlight can also occur. Pregnant women and children under the age of 8 should not use them. Most commonly, doxycycline is taken twice daily for 1-2 months then once daily for 2-3 months. In some cases a daily dose is used for many years.


 
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Copyright © 2009 Robert C. Arffa, M.D., 1370 Washington Pike, Bridgeville, PA 15017