A chronic inflammation of the eyelid margin. It is associated with obstruction of the openings of the meibomian glands (posterior blepharitis), or formation of scales at the bases of the eyelashes with mild inflammation and bacterial infection (anterior blepharitis). Secondary disruption of the tear film is common. The underlying cause is not clear. Posterior blepharitis may co-exist with rosacea of the face.
Clinical Features
Sore, uncomfortable, ‘tired’ eyes
Itching or grittiness
Foreign body sensation
Watering
Lid margins often red or thickened
Obstruction of the openings of the glands or scales on the lashes may be visible
Blepharitis predisposes to marginal keratitis
Management
Treatment aims to control symptoms as cure is unlikely
Careful cleaning of the lid margin with cotton buds dipped in very dilute baby shampoo (a drop in an egg-cup of water) or weak sodium bicarbonate solution ( a pinch of powder in an egg-cup of water). Aim to clean at the bases of the lashes of top and bottom eyelids initially twice per day then reduce as symptoms improve to around twice per week.
Artificial tear drop supplements are frequently helpful for dry eye symptoms but need to be used 4-6 times per day
An initial course of topical antibiotic ointment may be indicated if there is clear infection or significant inflammation
For patients with underlying rosacea a course of doxycycline for 2-3 months may be of benefit
See ophthalmologist if these measures fail to help
