Types of blepharitis
Based on the location of the inflammation, anterior and posterior blepharitis are distinguished. The front one affects the skin and the base of the eyelashes: staphylococci multiply here, scales accumulate during seborrhea, and demodex mites live. Posterior blepharitis is associated with dysfunction of the meibomian glands, located in the thickness of the eyelids at their inner edge: the secretion of the glands thickens, the ducts become clogged, and the tear film quickly evaporates. A mixed form is often found. Allergic blepharitis, which occurs as a result of a reaction to cosmetics and eye drops, is separately distinguished.
- Anterior staphylococcal
- Seborrheic
- Demodectic
- Posterior – dysfunction of the meibomian glands
- Mixed
- Allergic
Causes and risk factors
Blepharitis develops from a combination of several factors. In people with seborrheic dermatitis and rosacea, the sebaceous glands of the skin, including on the eyelids, are disrupted. Bacteria that normally live on the skin, when in excess, produce substances that irritate the edge of the eyelid. Demodex mites live in the hair follicles of many people's eyelashes, but when they multiply, they cause itching and characteristic mounds at the base of the eyelashes. Prolonged screen work with infrequent blinking, contact lenses, long-lasting cosmetics, dry air and air conditioners contribute to the disease.
- Seborrheic dermatitis
- Rosacea
- Reproduction of demodex
- Excess bacteria on the skin of the eyelids
- Meibomian gland dysfunction
- Computer work, air conditioning
- Eye cosmetics and their poor removal
Symptoms
Complaints are usually bilateral and worsen in the morning. The edges of the eyelids are red, thickened, scales or crusts are visible at the base of the eyelashes, and the eyelids sometimes stick together after sleep. Worries include itching, burning, sandy sensation, watery eyes or, conversely, dryness, increased sensitivity to light and wind. With posterior blepharitis, vision may become blurred for a short time and clear up after blinking, and the tear appears foamy. Over a long period of time, eyelashes fall out, grow incorrectly, and the edges of the eyelids become uneven. Styes and chalazions often appear.
- Redness and thickening of the eyelid margins
- Crusts and scales on eyelashes
- Itching and burning
- Feeling of sand in the eyes
- Foamy discharge in the corners of the eyes
- Eyelash loss
- Repeated styes and chalazions
Diagnostics
The diagnosis is made by an ophthalmologist by examining the eyelids at a slit lamp. The doctor evaluates the condition of the skin and eyelashes, the excretory ducts of the meibomian glands and their secretions, and checks the stability of the tear film. To confirm demodicosis, several eyelashes are taken from each eyelid and examined under a microscope. Culture of the discharge is prescribed in case of severe purulent inflammation or lack of effect from treatment. It is important to exclude diseases of the facial skin, and in case of unilateral persistent thickening of the eyelid with loss of eyelashes, a neoplasm, which may require a biopsy.
- Biomicroscopy of eyelids and eyelashes
- Examination of eyelashes for demodex
- Evaluation of meibomian gland secretion
- Tear film stability test
- Sowing from the edge of the eyelid according to indications
- Consultation with a dermatologist
Treatment and care for eyelids
The main thing in treatment is daily eyelid hygiene, which must be continued even after improvement. Warm compresses soften the secretion of the glands for 5–10 minutes, after which the eyelids are gently massaged and the edges are cleaned with special products or napkins. Moisturizing drops reduce dryness. As prescribed by the doctor, antibacterial ointments are used on the edges of the eyelids, anti-demodex agents, and for posterior blepharitis - courses of anti-inflammatory drugs. There are hardware procedures for warming up and cleansing the glands. At the same time, rosacea and seborrheic dermatitis are treated, and long-lasting cosmetics are abandoned.
- Warm compresses daily
- Massage the eyelids and cleanse their edges
- Moisturizing drops without preservatives
- Antibacterial ointments as prescribed
- Remedies against demodex
- Treatment of rosacea and seborrheic dermatitis
- Taking breaks when working on a screen
