A Family Doctor's Tale - BLEPHARITIS

DOC I HAVE BLEPHARITIS

Some morning you get up from your night sleep and find your eyelids stuck with some gluey mucus and you force your eyes open to find your eyes blurry because there is a sticky mucus discharge on your eyelashes.

This is infection of your eyelids or blepharitis.

Blepharitis ( A Simple Guide to Blepharitis) is a disease which causes inflammation and infection of the margins of the eyelids.


Bacterial Infections:
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1.Gram positive bacteria such as Streptococcus and Staphylococcus are common


2.Gram negative bacteria such as Klebsiella, E.coli, Pseudomonas,


Parasitic Infections:
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Deodex folliculorum rare cause


Non-infectious:
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blocked oil glands of eyelashes


Squamous:
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typically scales on lashes- usually non-infectious


Ulcerative:
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yellow crusts on eyelids which causes small bleeding ulcers when removed -usually due to infections.


Symptoms:

1.Irritation and discomfort of eyelids


2.tearing of eyes


3.photophobia (fear of bright lights and sunlight)


4.Yellow discharge or crusts on eyelashes


Signs:

1.White scales on eyelashes in squamous blepharitis


2.yellow crusts on eyelashes in infectious blepharitis


3.small bleeding ulcers on eyelids where crusts have dropped.


4.Conjunctivitis


5.Culture and sensitivity to antibiotics of the discharge from eyedlids


Complications of Blepharitis may result in:
1.Stye or chalazion of eyelid


2.Conjunctivitis


3.Scarring of eyelids


Treatment of Blepharitis depends on the type of Blepharitis:
Squamous Blepharitis
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1.Treat underlying cause such as seborrhoeic dermatitis


2.Application of antiseptic or antibiotic cream to eyelashes


Ulcerative Blepharitis
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1.Rest in dark room


2.Painkiller for pain


3.Removal of crusts and diseased eyelashes by washing warm water or saline


4.Strong antibiotic eye drops and cream applied to eyelashes:
a.cephalosporin, penicillin, ampicillin, tetracycline, for most streptococci, staphalococci, hemophilus bacteria


b.cephalosporins, gentamycin for pseudomonas


5.Treat associated conjunctivitis


Squamous Blepharitis
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Treatment by removal of the scales is generally good.


May vary with response to underlying cause.


Recurrence is common.


Ulcerative Blepharitis
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Most cases recovered well.


Rarely there may serious complications such as
loss of eyelashes,
scarring of eyelashes
conjunctival ulcers


Prevention of Blepharitis is by:
1.Avoid rubbing of eyes with dirty hands


2.Good hand hygiene


3.Healthy lifestyle with balance diet and adequate sleep.


4.Reducing watching of TV and computer monitors


5.Regular eye checkups