Blepharitis /ˌblɛ.fɚˈɑɪ̯.tɪs/ is an ocular disease characterized by inflammation of the eyelid margins. Blepharitis may cause redness of the eyes, itching and irritation of the eyelids in one or both eyes. Its appearance is often confused with conjunctivitis and due to its recurring nature it is the most common cause of "recurrent conjunctivitis" in older people. It is also often mistaken for "dry eye" by patients due to the gritty sensation that may occur, however lubricating drops do little to improve the condition.
A typical lid margin hygiene routine consists of 4 steps:
The following guide is very common but is more challenging to perform by visually disabled or frail patients as it requires good motor skills and a mirror. Compared to above it does not bear any advantages:
Depending on the degree of inflammation of the lid margin, a combination of topical antibiotic and steroid drops or ointments can be prescribed to provide instant relief. However, this harbors significant risks such as increased intraocular pressure and posterior subcapsular cataract formation. Since cataract formation is irreversible and even intraocular hypertension might be (harboring the risk of glaucoma with permanent visual loss), both need to be checked for monthly. Steroid-induced cataracts and ocular hypertension can affect all ages.
If acne rosacea coexists, treatment should be focused on this skin disorder as the underlying cause together with the above lid margin hygiene routine. Typically, 100 mg doxycycline by mouth twice per day is prescribed for four to six weeks which can be tapered to 50 mg once daily for several years. Some physicians use a lower starting dose. Patients are instructed to continue use for at least two months before symptoms improve significantly. Contrary to common belief, use of tetracycline-type antibiotics is not primarily to treat bacterial infection but rather to inhibit matrix metalloproteinases resulting in thinning of oil gland secretions and change of the characteristic prominent capillary pattern.
Dermatologists treat blepharitis similarly to seborrheic dermatitis by using safe topical anti-inflammatory medication like sulfacetamide or brief courses of a mild topical steroid. Although anti-fungals like ketoconazole (Nizoral) are commonly prescribed for seborrheic dermatitis, dermatologists and optometrists usually do not prescribe anti-fungals for seborrheic blepharitis.
If these conventional treatments for blepharitis do not bring relief, patients may consider allergy testing and ocular antihistamines. Allergic responses to dust mite feces and other allergens can cause lid inflammation, ocular irritation, and dry eyes. Prescription optical antihistamines and over-the-counter optical antihistamines are very safe and can bring almost immediate relief to patients whose lid inflammation is caused by allergies.
Patent Issued for Methods and Compositions for the Treatment of Infection or Infectious Colonization of the Eyelid, Ocular Surface, Skin or Ear
Oct 01, 2013; By a News Reporter-Staff News Editor at Life Science Weekly -- From Alexandria, Virginia, NewsRx journalists report that a patent...