Blepharitis

Each eye has two eyelids (upper and lower) that leave, when fully opened, the palpebral fissure, and in the areas of the extremities of the eye, when they join, they form the inner and outer edges.

Very close to the internal canthus there is a mound (the lacrimal tubercle) with a central hole, the lacrimal canaliculus, through which the tear that contains the lacrimal sac will be eliminated. The tear tubercle serves as a reference to divide the edge of the eyelid into two portions: an internal one, without eyelashes, where the meibomian glands are located, and an external one, where the eyelashes and the sebaceous and sweat glands associated with them are located.

It is a group of disorders with a common characteristic: chronic inflammation of the edge of the eyelid and its neighboring structures (base of the eyelashes, glands and conjunctiva, in this case being called blepharoconjunctivitis).

It is a very common eye disorder.

Many causes have been considered, among which there are two well established ones:
– Infectious: produced mainly by staphylococcus.
– Glandular alterations : abnormalities in the meibomian glands, with increased sebum secretion and even with plugging of the exit orifice.

There are diseases that predispose to blepharitis , such as rosacea and atopic dermatitis .

Symptoms of blepharitis

There are two clinical forms, which differ both by the cause that produces them and by the area of ​​the edge of the eyelid affected:

Staphylococcal blepharitis

Its cause is staph infection. It affects the outermost or anterior part of the edge of the eyelid, the one that contains the eyelashes.

It has stinging, itching, a feeling of grit inside the eye and intense discomfort with light. The edge of the eyelid reddens and scales appear that form a necklace around each lash. These can become lost, follow a different direction than normal or even turn white.The conjunctiva appears dry and red.

On very rare occasions this type of blepharitis can be complicated by dryness, inflammation, ulceration or even, more rarely, with perforation of the cornea.

Eczematous blepharitis

Caused by the alteration in the functioning of the meibomian glands. It affects the posterior or innermost portion of the edge of the eyelid.

It manifests as itching and redness of the eyelid, appearing a greasy discharge and crusts on the edge of the eyelid. Sometimes you can see a whitish and foamy substance on the edge of the eyelid, mixed with the tear, which is nothing more than the excess fat produced by the altered glands.

This clinical form of blepharitis is associated with an increase in generalized fat secretion in the person presenting it, and is also associated with seborrheic dermatitis.

How is it diagnosed?

The diagnosis is clinical, due to the symptoms of burning, itching, discomfort with light that the patient presents, as well as the appearance of redness of the eyelid and conjunctiva with the formation of scales or crusts around the eyelashes.

Treatment for blepharitis

General measures

They are common to both clinical forms and consist mainly of scrupulous hygiene by washing the edge of the eyelids and eyelashes with neutral soaps, brushing the eyelids from the base to the end, to squeeze the meibomian glands and eliminate the secretion.

The washing and expression process will clean the debris and remains of scales, crusts and bacteria (in the case of staphylococcal blepharitis) avoiding the complications derived.

Pharmacological measures

In staphylococcal blepharitis: an antibiotic treatment in the form of an ointment should be used after cleansing (bacitracin or neomycin are effective antibiotics against staphylocum).

Eczematous improves with local corticosteroids, although it often recurs frequently.

How to avoid it?

In infectious blepharitis, hygienic measures should be taken to avoid infection: avoid sweating reaching the eyes, avoid contact of the fingers with the eyelids when the eyelids are not sufficiently clean …

In eczematous there is no possible prevention of the disease, although there is of the complications as well as lessening the symptoms, with the appropriate general treatment and, if necessary, administering drug treatment.

When it presents, without apparent cause, discomfort and / or itching in the eyes and eyelids with redness associated with scales or scabs on the eyelashes of both eyes.

It is more suspicious that this type of disorder is suffered if the subject has as previous diseases seborrheic dermatitis, rosacea or atopic dermatitis.