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blepharitis

Alternative Names 
inflammation of the eyelids

Definition
Blepharitis is an inflammation of the eyelid. It develops at the place where the mucous membrane on the underside of the lid joins the skin on the top of the lid. It occurs in both children and adults. The condition can be chronic and recur.

What is going on in the body? 
The margin of the lid becomes inflamed along the eyelash line. Redness, scaling, and sometimes an infection can develop in the skin between the eyelashes.

What are the signs and symptoms of the disease? 
Symptoms of the condition include:
  • redness, swelling, burning, and crusting along the lid margins.
  • scaling that clings to the eyelashes.
  • ulceration of the skin and membranes. This produces weeping and swelling of the eyelids.
  • secondary conjunctivitis, which is inflammation of the lining of the inner eyelid and the white of the eye.
  • loss of eyelashes.
What are the causes and risks of the disease? 
The condition can be brought on by seborrhoea. This is a dandruff-like condition that can appear wherever there is hair on the body. It can occur at the root of the eyelashes. Blepharitis can also be aggravated by a bacterial infection. Staphylococcus is the most common cause.

What can be done to prevent the disease? 
Keeping the eyelids clean is important. This helps prevent infection. A person who is prone to the condition might also try putting a warm compress on the area daily.

How is the disease diagnosed? 
A doctor will form a diagnosis by examining the lid and eyelash area with a special instrument called a slit-lamp microscope.

What are the long-term effects of the disease? 
Blepharitis tends to occur repeatedly. The condition can lead to patchy loss of eyelashes. Eyelashes can grow in backwards. This can cause them to scratch the eyeball. Blepharitis can also create a tendency to develop infections in the glands of the eyelids. Styes, which are inflammations of the glands of the eyelid, and chalazions, which are enlargements of the oil glands of the eyelid, are common. If not controlled, the condition may lead to secondary conjunctivitis or even keratitis, which is an inflammation of the cornea.

What are the risks to others? 
Bacterial infections may develop in the eye. General cleanliness is important. An infected person should wash his or her hands before preparing meals and or having contact with others. It is also important that the individual not let others use his or her towel, washcloth, or pillowcase.

What are the treatments for the disease? 
Treatments include:
  • Daily cleaning of the lid with a clean cloth soaked in warm water.
  • Application of warm compresses to the lid and lids margins.
  • Cleaning of the lid margins with a cotton ball or cotton swab soaked with several drops of baby shampoo.
  • Topical antibiotic drops or ointment, such as chloromycetin. Oral antibiotics may be necessary in some cases.
  • Topical corticosteroid therapy with an agent such as hydrocortisone cream. This may help control swelling and redness.
What are the side effects of the treatments? 
When cleaning the eyelashes, the person needs to be careful not to touch the eye itself. If corticosteroids are used, checkups with an eye doctor are needed to rule out increased intraocular pressure, which is the pressure inside the eyeball.

What happens after treatment for the disease? 
This tends to be a chronic condition that is difficult to eliminate. Therefore, treatment must be started at the first sign of new symptoms or continued long-term.

How is the disease monitored? 
This condition is easily monitored by watching for symptoms. Often, cleaning the eyelids is all that is necessary to keep the condition under control. Antibiotics and corticosteroids may be needed for sudden flare-ups.

Author: 
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 23/07/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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