Blepharitis is a common inflammatory condition that affects the eyelids. It usually causes burning, itching and irritation of the lids. In severe cases, it may also cause styes, irritation and inflammation of the cornea (keratitis) and conjunctiva (conjunctivitis). Some patients have no symptoms at all. It usually responds well to simple treatment measures.

Blepharitis is usually a chronic problem that can be controlled with extra attention to lid hygiene. The basic problem is just accumulation of debris such as flakes of dead skin that remain attached to the lid margin together with grease from the skin, in many ways similar to dandruff. However, it is sometimes caused by an infection and may require medication.

Signs and Symptoms

Treatment

The key to controlling blepharitis is to keep the eyelids and eyelashes clean. Cleaning needs to be gentle yet thorough to remove adherent debris. Begin by soaking a clean washcloth in hot tap water. Place the compress on closed eyelids for five minutes, and then repeat. Next, gently scrub the eyelids with a washcloth or cotton swab soaked in a mixture of equal parts of baby shampoo and previously boiled water. Afterward, rinse the lids thoroughly with warm water.

This treatment should be repeated two to three times daily for two weeks, and then reduced to once daily. Like dandruff, there is no cure for blepharitis; but it can be controlled. In some cases, anti-inflammatory and antibiotic drops or ointments are necessary for flare-ups or more severe cases.

Blepharitis is commonly associated with dry eyes and the use of artificial tear preparations often helps relieve symptoms.

Some of these products are watery and alleviate the symptoms temporarily; others are thicker and adhere to the eye longer. Preservative-free tears are sometimes recommended because they have fewer additives that could potentially irritate. When choosing an artificial tear preparation it is often useful to try a few different brands. Patients often find that they are more comfortable with a particular brand of artificial tear preparation. Also, patients often find that a watery preparation is more useful during the daytime (eg Hypromellose or Sno-tears) as they do not cause blurring, but a thicker solution (eg Viscotears or Lacrilube) is useful before going to sleep as it provides alonger period of relief. All of these are available from a chemist without the need for a prescription, and are usually cheaper than the price of a NHS prescription. Commonly used preparations are -

• Hypromellose

• Sno-tears
• Viscotears
• Oxyal

• Refresh*

• Celluvisc*

• Lacrilube*

• Systane
• Optive*
• Vis-med*

(* these are preservative free)

With these measures it is possible to keep the symptoms under control and the eyes comfortable. These measures need to be carried on long term.