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Blepharitis

Definition:
Blepharitis is inflammation of the eyelid. It is a very common eye disease that affects the edge of the eyelids and eyelash hair follicles. There are three main types of blepharitis:

Seborrheic Blepharitis – Skin cells shed more rapidly than normal due to a sebaceous gland that is not functioning properly. The sebaceous gland secretes oil to the skin. The presence of excess oil and skin cells help bacteria to grow.

Infectious Blepharitis – Bacteria cause an infection in the glands along the eyelid.

Contact Dermatitis Blepharitis – Something coming in contact with the eyelid leads to local inflammation. For example, mascara may produce such an allergic reaction.

Causes:
The primary types of blepharitis are caused by either a skin condition or an infection. Blepharitis often occurs along with seborrheic dermatitis and acne rosacea.

Risk Factors:
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for blepharitis include:
  • Seborrheic dermatitis
  • Acne rosacea
  • Contact allergies
Symptoms:
Symptoms depend on the cause of the blepharitis. They are usually worse in the morning.

Symptoms may include:

  • Redness, flaky skin, and oily secretions along the edge of the eyelid
  • Crusty material clinging to the eyelashes
  • Dry scales or dandruff-type material on the scalp and eyebrows
  • Itching or burning sensation
  • Tearing
  • Sensation of a foreign object in the eye
  • Ulcers or sores at the base of the eyelashes (in severe cases)
  • Scant, broken eyelashes
  • Chalazions (nonpainful bumps in the eyelid), which may become infected (called a stye)
  • Conjunctivitis (occasionally)
Diagnosis:
The doctor will ask about your symptoms and medical history, and perform a physical exam. Initially you may not have any special tests. If the inflammation looks unusual for blepharitis or fails to respond to treatment, the doctor may culture the eye, by passing a swab across the edge of the lid. The swab is sent to a lab to see if bacteria grow and if so, what kind. Your ophthalmologist may also decide to perform a biopsy by removing a tiny piece of the eyelid margin for microscopic examination to be certain that there is no sign of cancer (rarely, some cancers can mimic chronic blepharitis).

Treatment:
Blepharitis is a chronic condition that often requires long-term management. Treatment depends on the cause of the condition. Your doctor may advise you not to wear contact lenses until the blepharitis has resolved.Hygiene

In mild cases, careful, daily eyelid hygiene may bring the inflammation under control:

  • Thoroughly wash your hands before performing any eye care.
  • Run a washcloth under warm water.
  • Place the warm washcloth on your eyelids for 5-15 minutes. This warm compress helps to loosen crust.
  • With your eyes closed, wash the eyelids with a special eyelid cleanser or diluted baby shampoo. Use a clean cotton ball for each eye.
  • Rinse with cool water.
Medication
If an infection is causing the blepharitis, you will be given antibiotic eye ointment. If your doctor advises, wash your eyelids as described above and apply the ointment with a cotton-tipped applicator. For a mild case, you may only need ointment at bedtime. If the infection is more severe, you may need to apply the ointment up to four times daily. Once resolved, your doctor may advise you to apply the ointment nightly to prevent another episode. If blepharitis returns after topical treatment, you may be given oral antibiotics, though this is rarely necessary.

Prevention:
If you are susceptible to blepharitis, conscientious eyelid hygiene can help prevent a recurrence:
  • Always wash your hands before touching your eyelids
  • Wash your hair and face daily
  • Wash your eyelids nightly as described above
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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