Blepharitis: Description
Inflammation of the eyelids (blepharitis) occurs when the excretory ducts of the sebaceous glands, which open to the outside at the eyelid margins, become blocked. Bacteria are often involved in such eyelid inflammation.
Since this disease often results in the formation of white-gray, greasy scales on the edge of the eyelid, it is also known as blepharitis squamosa. In severe cases, it can progress to ulcerative blepharitis with deeper skin lesions of the eyelid.
Blepharitis (blepharitis squamosa) is primarily referred to when the inflammation affects the entire eyelid. If, on the other hand, clogged sebaceous glands cause a narrow, painless swelling of the eyelid, this is a hailstone. A stye, on the other hand, is a painful, reddened swelling on the eyelid caused by inflammation of a sebaceous gland, usually bacterial.
Blepharitis: Symptoms
Common blepharitis symptoms include:
- dry, burning or itchy eyelid
- slightly reddened and scaly eyelid
- foreign body sensation in the eye
- increased falling out of eyelashes at the inflamed eyelid margin (madarosis)
- sometimes formation of fine scales on the eyelid margin
- sometimes slight swelling of the eyelid
Blepharitis: Causes and risk factors
The cause of blepharitis is a blockage of the sebaceous glands (meibomian glands) in the eyelids. This can have different causes:
In addition, external stimuli such as dust, wind, cold, heat, smoke, chemicals, cosmetics or contact lenses can also cause clogged sebaceous glands and thus eyelid rim inflammation. General diseases such as rheumatism, thyroid disease or diabetes are also possible causes of blepharitis.
Infectious blepharitis
- Staphylococci colonize the skin and mucous membrane even in healthy people. In the case of a small injury, they can penetrate the eyelid skin and cause inflammation.
- Crabs can be transmitted from person to person in poor hygienic conditions. Mostly they infest pubic hair, more rarely axillary and beard hair and very rarely also the eyelashes (phtiriasis palpebrarum). The hair on the head is not affected. In the context of lice inflammation, the nits of the lice adhere to the eyelashes as small granules. The lice themselves suck on the edge of the eyelid between the eyelashes.
Non-infectious blepharitis
If sebum production exceeds normal levels, the excretory ducts of the eyelid glands become clogged – a scaly eyelid margin inflammation (blepharitis squamosa) can develop. The excess secretion agglutinates the eyelashes and forms a greasy coating that can further clog the glands and cause inflammation if bacterial or viral colonization occurs.
Blepharitis: examinations and diagnosis
- Do you have slightly oily (seborrheic) skin? For example, did you suffer from acne as a teenager(s)?
- Do you suffer from copper rose (rosacea) or neurodermatitis (atopic dermatitis)?
- Do you wear contact lenses?
The ophthalmologist then examines the anterior and posterior lid margins with a magnifying glass. To do this, he carefully folds over the eyelid.
Blepharitis: treatment
Eyelid hygiene
The goal of eyelid hygiene is to ensure normal drainage of sebaceous secretions. This is usually achieved with two measures that should be performed daily:
- Cleaning of the eyelid margins (lid edges): The adhesions and encrustations on the eyelid margins that often accompany blepharitis can be loosened with a damp cloth, hypoallergenic soap and salicylic oil from the pharmacy. Then, the eyelid margins are cleaned with a special cleansing solution or with specially made lint-free cleansing pads. These special eye care products for eyelid rim inflammation are available at the pharmacy.
If the inflammation of the eyelid margin is caused by bacteria, it is treated with a local antibiotic preparation (e.g. antibiotic eye ointment). Only in rare cases the antibiotic is administered in the form of tablets.
In certain cases, local application of glucocorticoids (“cortisone”), for example as an ointment, may also be useful.
In the case of virus-related blepharitis, the doctor may prescribe a virus-inhibiting drug (virustatic agent) to be taken.
Treatment of skin diseases
If blepharitis is caused by a general skin disease, this must be treated at the same time in consultation with the treating ophthalmologist. Otherwise, blepharitis can recur quickly.
