Blepharitis - Causes, Symptoms and Treatment in Singapore

Blepharitis is a chronic inflammation of the eyelids and eyelash follicles. It is a common eye condition and typically manifests as swelling, redness, and crusts or flakes in the area around the eyelids. Although the condition does not pose a serious risk to a person, it may cause several eye problems. When the eyelid inflammation is severe, it can spread to the cornea and lead to the eyelashes falling off and deformation of the eyelids. Blepharitis can also cause other unpleasant complications such as sty (lump), chalazion or conjunctivitis.

Patients who suffer from eyelid infections often experience excessive tearing and extreme discomfort. There are many causes associated with blepharitis. However, the exact reason for the development of this eye disease remains unclear. Blepharitis requires prompt treatment, because if left untreated, it may result in various eye problems.

The purpose of this article is to provide you with a better understanding of this eye condition and provide information about your treatment options. However, this is general information only and cannot replace consulting with an eye specialist. Be sure to see an opthalmologist if you suspect you might suffer from blepharitis.

What triggers blepharitis: causes and risk factors

There are several reasons that may lead to the development of this condition. Some of the most common blepharitis causes are:

  • Accumulation of bacteria. Bacteria normally reside on the skin but in some people, more bacteria can collect at the base of the eyelashes causing eyelid inflammation.
  • Overactive oil glands. Blepharitis frequently occurs in people who tend to have oily skin. In such cases, oil glands may be overactive causing dandruff-like scales and particles to form along the lashes and lid margins which can cause redness, itching or burning.

Blepharitis may also occur from a number of pre-existing conditions such as:

  • Acne rosacea. It is a very common skin condition that occurs in the central part of the face. Sometimes it can spread into the eyelid margin and cause a lot of symptoms associated with blepharitis.
  • Allergies. Eyelid allergies can develop from contact lenses solutions, eye makeup, different cosmetics or some medications.
  • Dry eye syndrome. It is an eye condition where the tears cannot provide enough lubrication to keep the eyes comfortable. This may contribute to blepharitis.
  • Eyelash mites. These are microscopic organisms that reside at the base of the eyelashes. In most cases eyelash mites are harmless, but if you have too many of them, they can infect the eyelid margins and cause damage to the oil glands.

Types of blepharitis

close up on a eye of a woman

Blepharitis can be divided into three categories.

  • Anterior blepharitis (Seborrheic blepharitis). With this type of blepharitis, the infection is mostly on the front part of the eyelid. Anterior blepharitis is often accompanied by dandruff of the scalp and eyebrows. It is usually associated with bacteria and skin conditions.
  • Posterior blepharitis (meibomian gland dysfunction). In this case, blepharitis is at the inner edge of the eyelid where it makes contact with the eyeball. Meibomian glands disease is recognized as a primary cause of dry eye symptoms. This type of blepharitis usually results from abnormal oil production by eyelid glands.
  • Mixed blepharitis. Some patients can experience both seborrheic blepharitis and meibomian gland dysfunction.

What are the symptoms of blepharitis?

The main symptoms of blepharitis are:

  • Irritation
  • Itching
  • Increased redness
  • Swelling
  • Warmth in the surrounding area
  • Watery eyes
  • Crusting or flaking at the base of the eyelashes
  • Blurred vision.

Patients with a severe form of blepharitis may also have the following complications:

  • Abnormally growing or falling out eyelashes
  • Sores due to removed crusts which may leave scars
  • Lump at the base of the eyelashes (sty)
  • Eyelid cyst (chalazion)
  • Conjunctivitis (pink eye)
  • Corneal infection.

It's best to talk to an eye doctor if you experience any of the blepharitis signs listed above. It is important that you get properly diagnosed so the proper treatment can be initiated.

How to treat blepharitis?

There are slightly different treatments depending on the type and the severity of blepharitis you have. But the core principle of treating the condition is to address not only the consequences of the disease but also its causes.

First of all, it is important to keep your eyes clean and free from debris and pollutants. Your doctor will give you special instructions on how to remove the layer of pollutants and dead skin from the edges of the eyelids. In many cases, maintaining proper eye hygiene will be enough to alleviate blepharitis symptoms.

When routine cleaning does not give a result then your doctor might advise prescription treatments, including:

  • Topical application of antibiotics. Antibiotic treatment is a proven method to relieve blepharitis symptoms. You can find these products in a variety of forms, including eye drops, creams, and ointments. If necessary, your eye doctor may also prescribe antibiotics to help speed the healing process.
  • Steroid eyedrops or ointments. They are typically used for more severe blepharitis or in case you do not respond to other treatments.
  • Immune system medications. Studies have shown that some blepharitis symptoms can be alleviated with medications that affect the immune system.
  • Medications to treat underlying causes. In cases where pre-existing conditions, like rosacea or allergies, cause blepharitis, then treating the underlying condition is necessary.
  • Electromechanical lid margin debridement. The treatment can effectively remove bacteria, mites and open clogged oil glands.
  • IPL (intense pulsed light) therapy. This treatment method can open clogged eyelid glands.

Lifestyle and home remedies

asian woman cleaning her eyelids

The best way to manage the condition is to clean your eyelids daily to prevent bacteria and eye mites from building up on the lid margins. Here are some tips on how to clean your eyelids.

  • Keep your eyelids clean. The most important part of treating blepharitis is maintaining good eyelid hygiene. You need to clean your eyelids properly by using a moistened washcloth with a mild eyelid cleanser or baby shampoo. Don't use the same washcloth on both eyes. Also, make sure you washed your hands properly before start wiping your eyelashes. Cleaning every day prevents a place for bacteria to live.
  • Apply warm compresses. Take a clean washcloth, soak it in boiling water that has cooled down a bit and then apply this warm compress to the closed eyelids. You should do it for at least five minutes once or twice a day. Warm compresses will dilate the Meibomian glands allowing them to flow out and onto the ocular surface more easily. Another option that holds warmth longer is to heat a gel pack in the microwave. Whatever you do be sure not to make the compresses so hot that you burn your skin.
  • Scrubb gently the lid margin. The warm compress should be followed by eyelid scrubs. Soak a cotton bud in warm water and then use this to massage and scrub the lid margin. Do this gently.
  • Massage your eyelids. Just do a little eyelid massage by using the edges of the index fingers or a clean washcloth. Gently pull downwards across the top lid towards the eyelid eyelashes. Repeat it around 20 times. The same process can be used for the lower eyelids. Make sure you always push towards the lashes.
  • Enrich your diet with essential fatty acids. Omega 3 and Omega 9 essential fatty acids can be found in many vegetables, fish, legumes such as salmon, avocados, flaxseed, linseed and others. Many supplements that contain these acids are also available.
  • Avoid wearing makeup during the treatment process. Makeup may worsen the condition. Whenever you have blepharitis under control, you can resume applying eye make-up. It is advisable to always check that your cosmetic products are within date. Also, avoid sharing make-up with other people because cross-contamination can become an issue.
  • Keep your eyelids healthy. The eyelids and eyelashes play a crucial role in protecting the eyes from harmful environmental conditions such as sun exposure, pollutants, debris, oils and mucus so on. In addition, they have oil glands that produce lipids that keep ocular surface moisture and prevent tear evaporation. The eyelids should be kept healthy so that they can function properly.

FREQUENTLY ASKED QUESTIONS

Does blepharitis cause dry eye?

Yes, the condition may lead to dry eyes. Blepharitis can affect the tear film and damage the lacrimal gland, leading to more severe symptoms of dry eyes.

Is blepharitis painful?

It is more likely to be uncomfortable rather than painful. However, in some severe cases, blepharitis can become quite painful.

What is Demodex blepharitis?

It is blepharitis caused by a type of mites called Demodex folliculorum. The Demodex mite carries bacteria including streptococci and staphylococci on its surface. That bacteria can cause blepharitis.

Can blepharitis be cured?

The disease cannot be completely cured. In most cases, it is a chronic disease requiring daily attention. Symptoms can be effectively managed through appropriate treatment and good lid hygiene.

How to prevent blepharitis?

Blepharitis is difficult to prevent since it is linked to certain risk factors that are out of your control. However, it is still possible to minimize blepharitis’s symptoms and eyelid inflammation by following simple everyday steps, such as:

  • Be sure to clean your face and hands
  • Wash your eyelashes every day with baby shampoo or a special eyelid cleanser
  • Keep your hands away from itchy eyes
  • Always remove your eye makeup before going to sleep
  • Clean your eyes by wiping away any tears or eye drops
  • Make sure you clean your contact lenses with a fresh solution every time.

Can blepharitis cause blindness?

The condition does not lead to blindness. It can be uncomfortable and difficult to treat, but usually does not permanently damage your vision. However, blepharitis can result in eyelash problems and permanent alterations of the eyelids margin.

Can blepharitis cause headaches?

Blepharitis is usually not associated with headaches. Yet, this eye disorder may cause photophobia (incapability of tolerating light), which can result in headaches.

How long does blepharitis last?

You should notice improvements in your symptoms in the first week after starting treatment. However, you will need to continue taking your medications or applying antibiotics for up to three months. Despite your eye infection is getting better, it is important for you to finish the antibiotic course.

What is the best treatment for blepharitis?

Maintaining good eyelid hygiene and applying warm compresses are some of the best approaches to treating blepharitis. Also, studies have shown that the application of antibiotics to the eyelids can alleviate symptoms and resolve infections of the eyelids. However, once these antibiotics are discontinued the bacteria may return if there is still crust and debris in which to live. So cleaning the eyelashes is really one of the main treatments of blepharitis.

Have a question?