As if having dry, scratchy eyes wasn’t enough, it is often accompanied by a condition called blepharitis, a chronic, inflammatory disease of the eyelids in which bacteria overgrow and colonize along the inner lids and eyelashes. Blepharitis can come with one or more symptoms, including eye dryness, dandruff-like flakes on the lashes or lash-line, red, swollen upper and/or lower eyelids, tearing, itching, scratchiness, foreign body sensation and a greater tendency to develop sties (painful, bumpy eyelid infections) and chalazia (blocked, swollen eyelid glands).
Because tear glands contain antibodies to manage bacteria, having a dry eye condition encourages blepharitis, and because blepharitis inflames the eyelids and blocks tear glands, it can worsen dry eye conditions, and the dreadful cycle continues. Certain other conditions can also increase the severity of blepharitis, including allergies, contact lens use, seborrheic dermatitis, rosacea, poor immune function, rheumatoid arthritis, Sjogrens disease, low androgen levels, and, of course, normal aging.
“People can get blepharitis at any age,” says Doctor of Optometry Adria Anguita, “but it becomes more common as people age, since we tend to create fewer tears and produce fewer antibodies to bacteria, allowing germs to proliferate more readily.” It is estimated that more than 30% of all adults suffer at least some blepharitis symptoms like occasional eye dryness or a minor crusting of the lids or lashes upon waking, but for many they are slight enough to be ignored, allowing blepharitis to continue unchecked for years.
As time goes on, however, uncontrolled bacteria can create a biofilm that traps toxins and pushes them deep into the eyelid skin until they cause chronic inflammation, which can injure the eyelids and tear glands, reducing the tear production needed to temper bacteria. “Bacteria overgrowth can be hard to manage,” says Lindsey Walsh, OD, “due to the fact that eyelid margins and eyelashes rest up against the tender and sensitive eyes, making them difficult to clean effectively. So it can be easy for blepharitis to go from bad to worse to worst, making this a chronic condition.”
Although there is no cure for blepharitis, it can be managed with appropriate care. There are over-the-counter cleansers formulated specifically to cleanse lids and lashes without drying or damaging delicate eyelid skin like regular soaps can. Products we recommend are available at all Lake Eye locations and at many retail stores without a prescription. Warm compresses applied 1-3 times a day for 5-10 minutes will help loosen flakes and debris and open clogged glands and pores.
When at-home care fails to adequately relieve symptoms or if symptoms get worse, your Lake Eye doctor may prescribe antibiotic ointment for you to apply to your lash-line before bedtime, or even an oral antibiotic if problems are severe. He or she may also recommend BlephEx™, the first clinical treatment for blepharitis.
BlephEx is a patented device that contains a spinning medical-grade micro-sponge that your doctor applies along the edge of your lids and lashes to gently and precisely remove debris and carefully break up the bacterial biofilm that can cause chronic inflammation. This single-use micro-sponge is used with a special antibacterial cleanser proven to kill another cause of blepharitis, demodex folliculorum, a common species of face mite that lives in hair follicles. Though this mite is harmless in small numbers, too many can cause skin redness, itchiness and inflammation, so getting rid of them is an important part of the BlephEx system.
During treatment, your Lake Eye doctor will instill a numbing drop in each eye to assure comfort. Then he or she will gently and carefully apply the device to remove any toxic biofilm along your lid margin, and then rinse. BlephEx lasts only a few minutes and is well tolerated by most patients. By removing the toxic layer and killing any excess mites, your doctor can help you not only relieve symptoms, but also avoid further damage to tear glands associated with long-term inflammation, including chronic dry eye, eyelid distortion and dysfunction, swollen eyelid glands and other problems.
Your doctor will give you instructions for at-home care between BlephEx treatments, which are usually repeated every 4-6 months. “Regular BlephEx treatments and appropriate at-home care can allow many patients to be completely free from the awful symptoms associated with blepharitis,” says Dr. Walsh.
“And it can also help prevent damage to eyelids and tear glands,” adds Dr. Anguita, “making it more than a comfort and cosmetic application, but also a preventive medical treatment.”
If you have been diagnosed with blepharitis or have symptoms, talk to your Lake Eye doctor today.
Lake Eye Associates