Complications of Blepharitis

Blepharitis is the inflammation of the lids. It may have several etiologies and can result in many secondary conditions that are detrimental to ocular health. Patients often present with inflammation and redness of either the anterior, posterior or both areas of the lids. In addition, there is usually debris at the base of the lashes that further clogs the gland openings.

The Blepharitis blocks glandular openings on the lid surface decreasing secretions into the eye. This results in dry eyes with all the secondary complications. As a result, patients most often complain about burning, stinging and excessive tearing. Furthermore, corneal edema will cause photo phobia and blurred vision. Chronic Blepharitis ends in the eye lashes falling out as well.

Seborrheic Dermatitis ( dandruff) causes anterior Blepharitis and usually has a Staphylococcus component. Additional factors such as poor hygiene, poor diet, hormonal changes and even stress will exacerbate the condition. Exte
al factors like make up and pollution will also come into play making the patient’s symptoms worse. While bacteria is normally present on the lashes, these other factors permit them to become an abnormally large part of the lid community tipping the balance and increasing toxins in this very sensitive area.

Meibomian Gland Dysfunction causes posterior Blepharitis. These glands produce oils that are required as a component of normal tears. If these glands manufacture faulty oils or don’t secrete a normal volume into the eyes, the ocular surface will suffer and may result in surface damage.

Certain factors will predispose patients toward Blepharitis, such as a weakened immune system, Acne and poor hygiene. Having any or all of these will dramatically increase the likelihood of contracting and the severity of the condition. Furthermore, Blepharitis may result in secondary complications that may be worse then the condition itself. Fungal and bacterial infections, lid spasms, Dacryocystitis ( blocked ducts), Amoeboid infections, styes, and ultimate lid damage are all real possibilities if the condition goes untreated.

Therefore proper diagnosis and treatment is required. Complete therapy includes improving lid hygiene and avoiding exte
al factors like oily make up and hairspray. Lid surfaces must be cleaned with diluted baby shampoo twice per day followed by warm compresses for a minimum of 2 weeks. Lid massages should follow each compress to increase blood flow to the area. In addition, topical ointment like Tobradex often is applied to decrease the inflammation and bacterial flora. If the Meibomian glands are involved then oral antibiotics are usually added to the regimen.

Upon completion of the treatment, maintenance therapy should be performed at least 1-2 times per week indefinitely. Blepharitis often returns and must be carefully monitored. Finally, contact lens wear must be closely followed to prevent additional corneal involvement. nn