Blepharitis

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Blepharitis is a common chronic condition affecting the glands in the eyelids. These glands form an oily secretion, which is essential in the formation of a stable tear film.

Waxy secretions obstruct the tiny openings of the glands along the lids. When the oily secretions cannot escape, the lid margin becomes inflamed. When there are inadequate or poor quality oily secretions, the tear film loses its stability. The tears tend to break up, leaving areas of patchy drying on the front window of the eye, leading to discomfort. This process is sometimes related to other disorders of the sebaceous glands such as acne rosacea or seborrhoeic dermatitis.

Blepharitis is associated with chalazion formation, stye formation as well as marginal keratitis.

It is not possible to cure blepharitis and it may continue to cause discomfort from time to time. There are however some things that you can do to which will make things more comfortable.

Treatment (See handout)
  • Clean the lid margins. Do this with a cotton bud, after the lid has been warmed with a flannel or after taking a shower. The margins need to be massaged in order to encourage drainage of oily secretions.
  • Tear film supplements. There are many of these available. Do not use drops which whiten the eye, as these lead to rebound redness. It is best to try the various drops and gels available in order to see what works best for you. Gels tend to be better at night as they last longer and the associated blurring will not bother you.
  • Sometimes a low dose daily antibiotic such as doxycycline may be required for a few weeks. These have an anti-inflammatory effect. They may take several weeks to lead to an improvement.
  • Rarely, you will require steroid drops. An ophthalmologist should supervise this.
  • Omega 3 supplements in the form of fish oil are thought to be helpful.

Note the crusts around the lashes (collarettes) on the left and the inflamed
meibomian gland orifices on the right.

Please feel free to download
this information sheet about
how to manage your blepharitis.