Blepharitis: Causes & Treatments

Blepharitis

Blepharitis is an eye condition characterized by an inflammation of the eyelids which causes redness, itching and irritation. The underlying cause of blepharitis can vary and is often multifactorial.

The common eye condition is caused by either a skin disorder or a bacterial infection.

Blepharitis is generally not contagious and can affect patients of any age. While it can be very uncomfortable, it usually does not pose any danger to your vision.

There are two types of blepharitis: anterior and posterior.

Anterior blepharitis occurs on the front of your eyelids in the area where the eyelashes attach to the lid. This form is less common and is usually caused by a bacterial infection or seborrheic dermatitis, which is a skin disorder (dandruff) that causes flaking and itching of the skin on the scalp and eyebrows. Allergies or demodex mites on the eyelashes can also lead to this condition.

Posterior blepharitis occurs on the inner eyelid that is closer to the actual eyeball. This more common form is often caused by rosacea, dandruff or meibomian gland dysfunction (MGD) which affect the production of oil in your eyelids.

Some of the common causes include:

Bacterial infection: Bacteria, such as Staphylococcus, can colonize the skin and eyelids, leading to inflammation.
Meibomian gland dysfunction: The meibomian glands located along the eyelid margins secrete oils that help lubricate the eyes. Dysfunction of these glands can result in an imbalance of oil production, leading to the development of blepharitis.
Demodex mites: These microscopic mites inhabit the eyelash follicles and can contribute to inflammation when their numbers increase.
Allergic reactions: Allergens, such as pollen or certain cosmetics, can trigger an allergic response in the eyelids, leading to blepharitis symptoms.

Symptoms of Blepharitis

Blepharitis can vary greatly in severity and cause a variety of symptoms which include:

Red, swollen eyelids
Itching
Burning or gritty sensation
Excessive tearing
Dry eyes
Crusting on eyelids

If left untreated, symptoms can become more severe such as:

Blurred vision
Infections and styes
Loss of eyelashes or crooked eyelashes
Eye inflammation or erosion, particularly the cornea
Dilated capillaries
Irregular eyelid margin

Treatment for Blepharitis

Dr. Arlene Schwartz at Hartsdale Family Eyecare is a specialist who provides comprehensive care for various eye conditions, including blepharitis. She focuses on diagnosing and managing blepharitis by addressing its underlying causes. Dr. Schwartz’s approach may include:

Thorough examination: Dr. Schwartz will perform a comprehensive eye examination to assess the severity and underlying causes of blepharitis. This may involve evaluating the eyelids, tear film quality, and the function of the meibomian glands.
Treatment plan: Treatment for blepharitis depends on the cause of the condition but a very important aspect is keeping the eyelids clean. Based on the examination findings, Dr. Schwartz will develop a customized treatment plan tailored to the individual patient. Treatment options may include:
- Eyelid hygiene: Dr. Schwartz may recommend regular eyelid cleansing routines using warm compresses and gentle eyelid scrubs to remove debris, bacteria, or excess oils.
  
  Warm compresses are usually recommended to soak the lids and loosen any crust to be washed away. It is recommended to use a gentle cleaner such as Ocusoft Hypochlor Spray, but Hyclear Hypochlorous Spray is now the ideal choice to clean the area.
  
  HyClear is the next generation of hypochlorous acid for essential daily eyelid health management. With a broad-spectrum of antimicrobial activity from the pure hypochlorous acid .01%, HyClear kills most ocular pathogens in 15 seconds*.
Medications: Depending on the specific case, Dr. Schwartz may prescribe antibiotics or corticosteroids to address bacterial infections or reduce inflammation. In serious cases, steroidal treatment (usually drops) may be used.
Meibomian gland management: Dr. Schwartz may suggest techniques such as warm compresses, manual expression of the glands, or specialized devices to help manage meibomian gland dysfunction.
Allergy management: If allergies contribute to blepharitis, Dr. Schwartz may recommend identifying and avoiding allergens or using antihistamine eye drops to manage symptoms.
Ongoing care: Dr. Schwartz will provide ongoing monitoring and follow-up care to ensure the treatment plan is effective and make any necessary adjustments.

Blepharitis is typically a recurring condition so here are some tips for dealing with flare-ups:

Use an anti-dandruff shampoo when washing your hair
Massage the eyelids to release the oil from the meibomian glands
Use artificial tears to moisten eyes when they feel dry
Consider breaking from use of contact lenses during the time of the flare-up and or switching to daily disposable lenses.

The most important way to increase your comfort with blepharitis is by keeping good eyelid hygiene. We have an in-office procedure to reduce and alleviate blepharitis called BlephEx. It treats Demodex mites. Speak to Dr. Schwartz about which treatment is best for you.

Blepharitis is typically a recurring condition so here are some tips for dealing with flare-ups:

Use an anti-dandruff shampoo when washing your hair
Massage the eyelids to release the oil from the meibomian glands
Use artificial tears to moisten eyes when they feel dry
Consider breaking from use of contact lenses during the time of the flare-up and or switching to daily disposable lenses.

Intense Pulsed Light Therapy (IPL)

Intense Pulsed Light (IPL) Therapy, which has been traditionally used as a cosmetic procedure for treating facial skin conditions, effectively treats chronic dry eye and Meibomian Gland Dysfunction (MGD). In fact, IPL Therapy is among the more groundbreaking treatments for dry eye.

Intense Pulsed Light Therapy is a painless method that delivers pulses of light to liquefy and release oils that have hardened and clogged the meibomian glands in the eyelids. IPL also reduces eyelid redness and stimulates healthy gland function.

Dr. Arlene Schwartz will begin your IPL treatment by placing shields over your eyes to protect them from the light pulses. Following that, a thin layer of cooling gel will be applied to the treatment area and a small device will administer the pulses of light to the region around the eyelids. The pulses of light heat the skin around the eye and dislodge the oil buildup.

After administering IPL, Dr. Arlene Schwartz will express oil from the glands, which will restore normal oil flow in the tear film. Though patients usually notice improvement in dry eye symptoms following their first or second treatment, it is generally recommended they undergo an initial series of four IPL treatments, performed monthly over a period of four months. This ensures long-term success in treating both chronic dry eye syndrome and Meibomian Gland Dysfunction.

Depending on the severity of their dry eye condition, certain patients may require occasional maintenance treatments following the initial series of IPL treatments. It is not unusual to combine IPL treatments with other dry eye therapies in order to optimize effectiveness and promote healing.

Call Hartsdale Family Eyecare on 914-902-5079 to schedule an eye exam with Dr. Arlene Schwartz, our Hartsdale optometrist. Alternatively, book an appointment online here CLICK FOR AN APPOINTMENT

LipiFlow

LipiFlow, by Johnson & Johnson Vision, is a Thermal Pulsation System that improves the function of meibomian glands. FDA-approved, safe and totally drug-free, it consists of a console and a single-use sterile Activator tool. Through gentle massage and heat, LipiFlow can enhance the quality of meibomian gland secretions. Eye doctors around the world are equipping their eye care clinics with this breakthrough technology to treat dry eye.

How does LipiFlow work?

Your eye doctor will begin by inserting numbing eye drops to ensure patient comfort. LipiFlow’s contoured eyepiece will then be placed gently over your cornea, vaulting over your eye’s surface in order to protect the delicate ocular structure. LipiFlow applies therapeutic heat and peristaltic energy pressure, with numerous sensors that regulate the temperature and pressure pulses. The combination of massage and heat works to expel any meibomian gland obstructions. The entire in-office procedure takes about 12 minutes.

TearCare

What Is TearCare?

TearCare® is the blink-assisted device that applies heat to the eyelids in applications such as Meibomian Gland Dysfunction (MGD), Dry Eye, or Blepharitis where the current medical community would recommend the application of a warm compress.