Blepharitis or eyelid rim inflammation is a common eye condition. Itchy, burning and red eyes and adhesions at the eyelid margins, especially after waking up, are the typical complaints. There are various causes of blepharitis. Eyelid rim inflammation can also become chronic.
What is blepharitis?
Blepharitis is the medical term for inflammation of the eyelids. It often occurs together with conjunctivitis. In blepharitis or eyelid rim inflammation, the eyelid margins are inflamed. Eyelid rim inflammation can be caused by bacterial infections. However, non-infectious reasons can also be responsible. Blepharitis can recur in some cases and thus become chronic. Acute inflammation usually heals within a short time, provided it is treated properly. Eyelid rim inflammation that is not treated can cause damage to the eyes. Medical treatment is therefore always advisable. Typical complaints are reddened, burning and itchy eyes. Especially after waking up, the eyelid margins may be stuck together. Depending on the cause of the condition, various therapies are used to treat blepharitis.
Causes
There can be several causes of blepharitis. In many cases, it is caused by a bacterial infection. Among these, staphylococci are the most common triggers for the infection. Staphylococci are found on the skin of most people. They produce various substances that can cause inflammation in a weakened immune system. An infection caused by staphylococci can often become chronic because the bacteria are constantly on the skin. In addition, eyelid rim inflammation can be caused by infections, by other bacteria or viruses. Crabs or mites also sometimes cause blepharitis. Various malfunctions of the sebaceous glands and the skin disease rosacea are also sometimes the cause of the disease. In addition, allergic reactions, as well as external irritants such as drafts, heat, cold, dust, chemical substances, smoke and frequent eye rubbing are still possible causes of blepharitis.
Symptoms, complaints, and signs
Blepharitis typically causes burning and itching in the eyes. In most cases, the eyes are also very red and sticky. Especially in the morning after waking up, the eyelid margins are heavily crusted and/or stuck together, and the eyes cannot be opened easily. The affected person also feels a foreign body sensation that increases during the course of the inflammation and causes a strong feeling of discomfort. Inflammation of the eyelid margin can lead to the development of scales on the eyelid margin or eyelash line. In addition to the eyes, the eyelid margins are also reddened and moist, which gives them the typical shine. Due to the discharge, the eyelashes stick together and subsequently appear oily and greasy. In some cases, small oily droplets form around the eyes, which can cause a severe burning sensation if they enter the eye. Blepharitis is sometimes associated with other symptoms such as fever or flu. Then symptoms such as fatigue, an increased pulse and secretion from the nose can be added. Externally, an inflammation of the lenticular rim can be recognized by the noticeable redness and adhesions. Based on these signs, the disease can usually be clearly diagnosed.
Diagnosis and course
To diagnose blepharitis, the doctor first asks about any symptoms. Itchy, burning and reddened eyes and adhesions after waking up are usually clear indications of an existing eyelid rim inflammation. To confirm the diagnosis, the ophthalmologist looks at the eye with a slit lamp. A slit lamp casts a slit-shaped beam of light onto the eye and at the same time makes it possible for the doctor to view the eye in magnified form. If the typical symptoms of blepharitis occur, a clarification by an ophthalmologist should definitely take place.
Complications
If left untreated, eyelid rim inflammation can lead to damage to the eye. Thus, chronic conjunctivitis, scarring of the eyelid margin, and loss of eyelashes may occur. Acute blepharitis heals with treatment within a few days or weeks. Chronic inflammation of the eyelid margins cannot be cured. However, with appropriate treatment, the symptoms of chronic blepharitis can be alleviated.Blepharitis mainly causes complications and discomfort in the eyes. Itching or burning sensation in the eyes may occur. The quality of life is extremely reduced by blepharitis and the symptoms occur mainly after the patient has slept. If blepharitis is not treated by a doctor, it can cause severe damage and inflammation to the eye. In this case, conjunctivitis may develop. The treatment itself can take several days or weeks and depends on the severity of the inflammation. The treatment is primarily aimed at alleviating the symptoms. The affected person must take antibiotics for a certain period of time and is dependent on eye drops or eye ointments. No further complications or complaints occur and the course of the disease is positive. Due to blepharitis, the patient is only slightly restricted in his everyday life. However, dusty and smoky areas must be avoided to prevent further discomfort to the eye and to prevent the healing process.
When should one go to the doctor?
Whether blepharitis requires medical treatment is determined by its duration, spread, and cause. It is important to distinguish between infectious and non-infectious eyelid rim inflammation. If classic signs of inflammation (redness, swelling, pain) are present, it is in most cases an infectious blepharitis. The causative agents are frequently bacterial pathogens, more rarely viruses or parasites. Therefore, treatment must be carried out by an ophthalmologist according to the specific pathogen. Self-treatment is not advisable because there is a risk of spreading the pathogens to surrounding areas. In the worst case, this leads to an extension of the local infection to the conjunctiva or cornea of the eye. Non-infectious blepharitis, which is caused by a malfunction of the sebaceous glands in the eyelid (meibomian gland dysfunction, MDD), can initially be treated by the patient himself if he is otherwise symptom-free. The recommended cleansing regimen (application of warm moist compresses, eyelid massage and eyelid cleansing) should be applied twice daily over a period of three to four weeks. The use of a tear substitute can additionally support healing. If there is no significant improvement in symptoms after a few weeks or if additional complications occur, an ophthalmologist should be consulted. Certain underlying diseases (rosacea, atopic dermatitis, seborrheic skin) favor the occurrence of eyelid margin inflammation. In the case of frequently recurring blepharitis, it is therefore advisable to have it clarified by a specialist in dermatology.
Treatment and therapy
Blepharitis can be treated by various measures. If bacterial infections are the cause, eye ointments containing antibiotics are applied. In some cases, an antibiotic must be taken in the form of tablets. In almost all forms of blepharitis, eye ointments containing anti-inflammatory agents are administered. Sometimes a disorder of tear flow also occurs due to inflammation of the eyelid margin. In these cases, the doctor will prescribe tear replacement fluid in the form of eye drops. If other diseases are the cause of blepharitis, they are treated accordingly. In addition to all drug treatments, the eyelid should be cleaned daily to support the therapy. Incrustations should be carefully removed and the eyelid should be cleaned. Thus, absolute hygiene should be observed to prevent any bacteria that may be present from spreading further. Warm and moist compresses can help to liquefy hardened sebum in the eyelid margins. All supportive measures can relieve the discomfort of blepharitis.
Outlook and prognosis
The prognosis of blepharitis depends on the course of the disease. If the symptoms become chronic, there is a possibility that the patient will suffer from the inflammation for many years. A weakened immune system and advanced age of the affected person are also unfavorable for a complete cure. Good prospects are given if the patient seeks early treatment, is in middle adulthood, and has no pre-existing conditions. With a healthy lifestyle and a balanced diet, the organism often has sufficient defenses to cure the inflammation on its own. With medical care of the eye, the healing process is shortened to a significant degree.Delays may occur if the patient develops an intolerance to the prescribed medication. Although there are a variety of alternative medicines, the physical reaction due to the allergy can further weaken the immune system. Thus, the organism has too few resources to successfully defend itself against the pathogens. In severe cases, the inflammation of the eyelid margin can lead to further germs entering the body. This can lead to the development of additional diseases, for which the chances of cure are uncertain. If the doctor’s instructions are followed and the eyelid is additionally relieved by self-help measures, healing is possible within a few days or weeks.
Prevention
There are no preventive measures against acute blepharitis. Acute eyelid rim inflammation can only be treated and the symptoms alleviated by appropriate treatment. If the inflammation of the eyelid margin is chronic, the eyelid should be cleaned hygienically every day. Stimuli that can trigger inflammation of the eyelid margin should also be avoided as far as possible. Draught, smoke or dust are among the factors that can cause blepharitis.
Aftercare
In the case of healed and treated acute blepharitis, medical aftercare in the actual sense is not necessary. Only if the eyelids or eyes have been affected due to infection and swelling, temporary eye care is recommended. This may consist of the precautionary use of moisturizers or decongestant creams. Once blepharitis has been overcome, those affected should also refrain from irritating their eyes unnecessarily. From a hygienic point of view, regular washing of the face is sufficient. Manipulation of the eyelids or eyes with fingers is not necessary, as long as it is not related to the administration of medication. Otherwise, there are no significant possibilities of aftercare, since acute blepharitis can usually be treated without complications. The chronic form of blepharitis can also be well controlled by medication and eye hygiene. It is therefore not necessary to take special measures if one’s own eyelids were once inflamed. On the contrary, misunderstood and excessive hygiene can also endanger the eye. Thus, excessive hygiene measures often lead to dry eyes, injuries or irritations – all factors that promote the development of blepharitis. However, people who frequently suffer from blepharitis should visit their ophthalmologist more frequently accordingly.
What you can do yourself
To prevent eyelid rim inflammation, it is important not to expose the eyes to unnecessary irritation, such as intense sun exposure without sunglasses, exposure to dust, irritation from dust, or dehydration from heating air in the winter. In the case of eyelid margin inflammation, it is very important to ensure adequate eyelid margin hygiene. This begins with moist warm compresses to liquefy the viscous secretion that clogs the lacrimal glands. To do this, you can moisten a fresh cloth or washcloth with warm water and place it on the eyes for about five to ten minutes. Please use only once and then put it in the wash. Then massage the eyelid rim with cleaned hands or a cotton swab towards the eyelashes to clear the clogged glands of secretion. After that, careful eyelid margin cleaning is important. It is best to take a cleaning solution from the pharmacy and use non-fluffy cotton swabs or pads. To avoid inflammation, all aids must always be used only once and also not for both eyes together. Dip the absorbent cotton into the cleaning solution and then carefully remove any encrustations or secretion residues from the outer eye.
