Blepharitis: The importance of early diagnosis and treatment

Blepharitis is a common and frequently recurring condition that affects the eyelids, leading to persistent symptoms that can affect quality of life.

This article provides an expert insight into blepharitis, discussing its causes, diagnosis, and treatment options.

What is blepharitis, and how does it affect the eyes?

Blepharitis is an inflammation of the eyelids that occurs when the oil glands located near the base of the eyelashes become clogged or inflamed due to bacterial infections, dysfunction of the meibomian glands, or skin conditions like rosacea.

Blepharitis is classified into two types: anterior blepharitis (which affects the outside edge of the eyelid near the eyelashes) and posterior blepharitis (which affects the inner edge of the eyelid that comes into contact with the eye).

Symptoms of blepharitis can vary but often include:

• red, swollen, or itchy eyelids
• grittiness or a burning sensation in the eyes
• excessive tearing
• crusting along the lashes
• sensitivity to light

These symptoms can be intermittent, flaring up and subsiding over time, or they may persist chronically.

Can blepharitis lead to other eye problems if left untreated?

If not properly managed, blepharitis can disrupt the stability of the eye’s tear film, leading to blurred vision and dry eye syndrome. Additionally, untreated blepharitis can increase the risk of developing styes (lumps), chalazions (cysts), or conjunctivitis (inflammation of the eye’s outer membrane).

In severe cases, blepharitis can also affect the cornea, the transparent front layer of the eye. Persistent irritation and inflammation can lead to corneal ulcers or scarring, which impact vision and require more intensive treatment. Early diagnosis and effective management of blepharitis are essential to avoid these complications.

How is blepharitis diagnosed and treated?

An optometrist can diagnose blepharitis through a clinical examination. During the evaluation, your optometrist will use specialised instruments, such as a slit-lamp microscope, to assess your eyelids, eyelashes, and tear film. In some cases, your optometrist may take a sample of eyelid crust or oil secretions for laboratory analysis to rule out bacterial infections or other underlying causes.

Treatment for blepharitis focuses on reducing inflammation, alleviating symptoms, and preventing further complications.

For mild cases, a consistent eyelid hygiene routine is essential. This involves cleaning your eyelids daily with a warm compress to loosen crusts, followed by gentle scrubbing with a prescribed cleanser or pre-moistened eyelid wipe to remove debris and excess oil.

For more persistent cases, additional treatments will be necessary. These can include antibiotic ointments to fight bacterial infections, steroid eye drops to reduce inflammation, or oral medications for rosacea-related blepharitis.

For severe or unresponsive cases, specialised treatments like thermal pulsation therapy or in-office eyelid cleaning procedures will be performed. These advanced treatment options target the blocked oil glands to provide more effective relief.

If you also have dry eye syndrome, your optometrist will prescribe artificial tears or lubricating eye drops to relieve discomfort and maintain a healthy tear film.