Blepharitis

Blepharitis is inflammation of the eyelids. This is categorised as anterior blepharitis- the lashes, and posterior blepharitis - meibomian gland dysfunction. Sometimes the condition is definitely one or the other, but often these occur together.

Anterior Blepharitis

In some cases the crusting at the base of the eyelashes is visible with the naked eye. Or it can be found only with a microscope view.

The type of material can reveal if the cause is demodex, small microscopic mites which live in the lash follicles.

Treatment involves regular lid hygiene.

Lid Hygiene

Regular cleaning of the eye lid margins is useful for blepharitis where scaly material accumulates at the base of the eye lashes.

Using a warm flannel or cloth can be a start but there are product formulations which work more effectively. We recommend foam cleaners (Sterilid or Blephadex), or wipes (Systane Lid Wipes or Lid ‘n Lash). Using the cleaner or wipes at least 3-4 times per week will get the best results.

Previously people were advised to use diluted baby shampoo. This no longer recommended as this can exacerbate inflammation.

Posterior Blepharitis, Meibomian Gland Dysfunction (MGD)

Meibomian glands line the edge of the upper and lower eyelids, secreting healthy oils onto the surface of the tear film which covers the eye. Blinking action draws the liquid oil secretions from these glands. This oily layer is vital to help the tear film stick on the eye’s surface, and also to give optimum vision.

MGD, or posterior blepharitis, describes the common condition where the oils in these glands become stagnant and thick. The effect can range from minor dry eye symptoms, through to chronic dry eye discomfort and blurry vision. The eyelids itself can become inflamed, and sometime these glands can harbour a low grade infection.

What is the best treatment?

We recommend regular warm lid compresses treatment, once or twice daily.

Taking omega-3 supplements can also be beneficial.

Using lid hygiene products can be beneficial, as well as treatment to the lid margin to reduce inflammation.

Dry eye appointments are helpful. These usually involve and assessment of the tear film, heat treatment, lid exfoliation and gland expression.

Warm Lid Compresses

Step 1: Apply sustained heat to the closed eye for at least 2 minutes. We recommend using an eye wheat bag or mask.

Step 2: Using the pad of a finger gently and firmly palpate along the lower and upper eyelid margins (one lid at a time).

Lower lid - looking up, apply pressure with the finger tip to the lid margin close to the eye lash line. You should be able to feel the edge of the eyelid under your finger tip. Press gently squeezing the eyelid between your finger tip and your eye. Work along the eye lid, which should take about 5 presses. Work back and forth at least twice.

Upper lid - look slightly down and repeat the process for the upper lid. You need to be pressing on the first 5mm from the edge of the lid.

When is the best time of day to do this? Whenever it works for you. Try to create an easy routine. Leave the wheat bag next to the microwave. Heat it while you make a cup of tea. Or before bed. All you need is the warm wheat bag, 2 minutes and clean finger tips.

Omega-3 Supplements

Omega-3 supplement supports meibomian gland function. We have many people who experience relief from dry eye symptoms within a few weeks of regularly taking omega-3. We stock two supplements: Thera Tears Nutrition and Lacritec.