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Blepharitis is a very common chronic inflammatory disease of the eyelids. Blepharitis may have an anterior and/or posterior component. Anterior Eyelid Margin Disease is crusting on the eyelashes due to a superficial infection and inflammation caused by a variety of micro-organisms. Posterior Eyelid Margin Disease is dysfunction of the oil glands within the eyelids (near the base of the eyelashes). An oily and unstable tear film results in dry, irritated, red eyes.
Excessive matter and crusting on the eyelids upon awakening; a gritty feeling in the eyes; a burning sensation that is worse while reading, driving, watching T.V., or working at the computer. Individuals with blepharitis may also experience itchy and red or irritated eyelids.
Blepharitis is a chronic problem that may come and go throughout one's life. Some form of treatment may be required from time to time to adequately control the symptoms associated with blepharitis. Short-term use of topical antibiotic or corticosteroid drops or ointment applied to the eyelid margin may be helpful, but eyelid hygiene is essential and the most effective long-term treatment of blepharitis. Eyelid hygiene techniques are outlined below and include warm compresses, lid margin scrubs, and lid massages. Like brushing your teeth, regular eyelid hygiene practices are important in the treatment of blepharitis.
The purpose of warm compresses is to open up the pores at the ends of the ducts where the glands drain onto the margins of the eyelids and ultimately into the eye. Warm compresses are warm or hot soaks placed over the closed eyelids.
The best way to perform at least one of your hot compresses each day is to do so while in the shower. Turn the water temperature up a few degrees, place a face cloth across your eyes, turn your face toward the water stream, and allow your face and eyelids to soak in the warm water for five minutes or so (perhaps while you have conditioner soaking in your hair). Hot compresses should also be applied upon awakening and prior to going to bed. A dampened face cloth should be placed across the eyes for ten minutes. The face cloth may need to be reheated with hot tap water after four or five minutes. Some individuals like to heat a dampened face cloth in the microwave. This may help retain the heat within the cloth; however this must be done with extreme caution so as not to overheat the cloth and burn the skin. Be careful not to burn yourself with hot compresses. Remember, the compresses should be warm to hot, NOT scalding.
The purpose of lid massages is to massage the thick and irritating oils out of the eyelid and into the tear film. For the patients with adequate manual dexterity, lid massages should be performed directly following hot compresses. With the eyelids closed, the upper eyelids are massaged downward and the lower eyelids are massaged upward.
The purpose of eyelid margin scrubs is to clean the eyelashes and eyelid margin and to mechanically remove many of the micro-organisms that are growing on the edge of the eyelid.
Dilute Baby Shampoo (Johnson's No Tears or other similar brand) should be placed on a warm, damp wash cloth. The eyelashes and eyelid margin should be scrubbed with a back and forth motion with the eyes closed. Baby shampoo is used to limit eye irritation. This may be performed while in the shower or just prior to bedtime.
Eyelid scrub pads are also available for purchase in most convenience and grocery stores.
Stephen R. Klapper, M.D., F.A.C.S. is a board certified Ophthalmologist and has completed extensive fellowship training in Ophthalmic Plastic and Reconstructive Surgery. In addition to his clinical practice Dr. Klapper has published numerous scientific articles in peer reviewed journals and presented several papers at regional, national, and international meetings on topics related to the field of eyelid and facial plastic surgery. Dr. Klapper's practice is limited to adult and pediatric cosmetic and reconstructive eyelid and facial surgery, tear duct surgery, orbital disease, thyroid eye disease and the anophthalmic patient. Dr. Klapper also has extensive experience performing facial Botox® injections and Restylane® lip and facial fold injections.
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Contact our office to discuss your eyelid problem with Dr. Klapper or a member of his staff. (317) 818-1000
