Blepharitis: clinic and treatment1
What is Blepharitis?
Blepharitis - a large group of eye diseases including chronic inflammation of the eyelid margins. Treatment of such diseases is difficult.
What triggers Blepharitis?
Causes of blepharitis vary. Edge of the eyelids can be affected by Demodex mites.
80% of people have these mites living on the surface of the skin,in the sebaceous glands in hair follicles.
By reducing the body's resistance, due to exhaustion, hypothermia or any previous diseases, ticks become active, proliferate, and get on the eyelid skin, the eyelashes, causing Demodectic blepharitis.
Some people who have hypersensitivity to different irritants (dust, cosmetics, pollen) may develop an allergic blepharitis. Usually it is complicated by inflammation of the mucous membranes of the eyes (conjunctivitis).
Blepharitis often accompanies diabetes, and diseases of the digestive organs: gastritis, colitis, cholecystitis.
Blepharitis often occurs in long-sighted people if they do not wear glasses. Eye muscles come in tension and get tired, people feel uncomfortable, rub their eyes and hands can bring the infection.
Sometimes, the infection gets into the eyelid skin with blood and lymph from the patient's tooth, from the tonsils in chronic tonsillitis, from any other source of infection.
Symptoms of Blepharitis
Characteristic features and conditions of distinction:• Scaled (B. squamosa), or plain (B. simplex), - blepharitis, characterized by hyperemia and thickening of the eyelid with the formation of flakes of desquamated epithelium of sebaceous glands and epidermis tightly attached to the skin near the eyelashes.
• Ulcerative (B. ulcerosa) - blepharitis is characterized by purulent inflammation of the eyelash follicles and the formation of ulcers on the margin of the eyelids.
Eyelashes can stick together at the basis, a yellowish crust is forming, the skin becomes ulcerated, on the place of the ulcers scars are formed. In severe cases, lashes fall out, the front edge of the eyelid may become wrinkled.
• Seborrheic blepharitis
Is frequently associated with seborrheic dermatitis of the scalp, eyebrows. Milder than ulcerative blepharitis. There is gray greasy scaling along the eyelashes. After removal of scales bleeding ulcers are left, as in ulcerative blepharitis. Sometimes there is loss and graying of eyelashes.
• Meibomian blepharitis from Lat. Glandulae Meibomi- blepharitis occurs due to hypersecretion of cartilage glands and deficiency of removing secretions.
• Rosacea (B. rosacea, from Lat. Rosaceus - Pink) - blepharitis, characterized by the appearance on the skin of small grayish-red nodules, topped with pustules, often combined with pink acne. Today for treatment of rosacea dermatologists recommend Azelaic Acid Cream.
• Demodectic blepharitis
• Allergic blepharitis
Usually is combined with an inflammation of the mucous membrane, there is extreme sensitivity to drugs, cosmetics and perfumes, pollen, dust (or home production), cockroaches, fur, feather, feathers, tools, household chemicals, pesticides, detergents, and chemical pollution. Acute allergic blepharitis occurs suddenly: swelling of the eyelids, tearing, mucous discharge, pain in eyes, itchy eyelids, photophobia.
Usually both eyes are affected.
Seasonal exacerbation is common in blepharitis caused by pollen during flowering herbs and trees. Herbal blepharitis often develops after prolonged use of eye drops and ointments, but can also occur with the introduction of drugs inside.
Disease begins from redness, swelling of eyelid skin, itching, thickening of the eyelids, loss of eyelashes.
Especially dangerous when eyelashes begin to grow in the direction of the cornea and scratch it. It can form erosion and ulcer of the cornea, threatening the loss of sight.Scarring sores can lead to deformation of the margin, abnormal growth of eyelashes that grow in different directions, even can grow in the direction of the eye, constantly irritating it. Lashes are sparse, thin, easy to fall out, badly grow new ones. The disease can occur without formation of scales and ulcers.
Diagnosis of BlepharitisDiagnosis of blepharitis is based on the clinical picture.
Treatment of BlepharitisScientists have achieved a lot in the development of treatment of blepharitis.
Nevertheless, treatment of blepharitis is difficult and long. It requires patience and persistence from both the physician and the patient. It is important to identify and eliminate the cause of the disease. Otherwise, it will recur and progress despite of treatment.
A patient if he wants to get well soon, should scrupulously follow a doctor's prescription.
Careful hygiene will help recovery. Handling eyelids with wet lotion or blurring the edges of the eyelids with ointment is good. On the eyelid may be applied a complex ointment containing a corticosteroid and an antibiotic: norfloxacin eye drops (dexamethasone 0.1% + Norfloxacin Ear / Eye Drops).
Hygiene occupies an important place. With the purpose of treatment are prescribed: blurring the edges of the eyelids with ointment hydrocortisone (hydrocortisone - 1%, and if severe - 2,5%), instillation of eye drops "artificial tears": a tear, natural or oftagel. Against the symptoms of conjunctivitis drops of dexamethasone 0.1% or Lotemax ( Loteprednol 0.5%) are used.
The main goal of treatment - to reduce the level of damage ticks. Serious hygienic care is recomended. Use eye ointment, hydrocortisone 2.5%, eye ointment gentamicin. It is important to apply ointment on eyelid abundantly before going to bed, because it breaks the life cycle of ticks. Against the symptoms of conjunctivitis drops of dexamethasone 0.1% or Lotemax ( Loteprednol 0.5%) may be used.
Elimination of "guilty" allergen, if possible - is the most effective and safest method of treatment. Treatment includes antiallergic eye drops and blur the edges of the eyelid with anti-inflammatory corticosteroid eye ointment (hydrocortisone). Also use of systemic antiallergic tablets gives good results. One of the best antiallergic drugs of the last generation is Clarinex (Desloratadine). If it is too expensive you may try Cetirizine HCL (Generic Zyrtec).
In case of blepharitis you should contact a doctor for an eye examination, especially after 40 years. At this age, due to the decrease of refractive power of lens eyes become tired quickly. In this case inflammatory disease of the ciliated edges of eyelid is often developed.
Those who have allergic blepharitis, should protect their eyes from dust, wear sunglasses, do not use mascara, eye shadow, and during the flowering plants try not to leave the town.
Each morning begins with hygiene procedures. Remember that if you were affected by blepharitis, do not tolerate cold water. You can continue to hardening (even a cold shower, even a hole), but only alternate it with warm water.
Cold water causes venous congestion and exacerbate the disease, warm causes arterial hyperemia that contributes to the fight against disease.
After washing massage is required. Before this procedure, it would be good to drop into the eyes of a 2% solution of novocaine or 0.25% dicaine to relieve discomfort.
Most important is the full 8-hour night's sleep. Try to give your eyes rest during the day: at least a few minutes, lie down or sit with eyes closed.
TV watching no more than two hours and a distance of not less than 4 meters. The eyes should "walk" and not look at one point.
Protect your eyes from dust and sun with sunglasses, especially in spring when the disease may worsen due to ultraviolet rays of the sun. Therefore, it is better not to sunbathe in the summer and stay in the shade.
Prevention of Blepharitis:
Need to respect hygiene rules:
- Do not wipe the face of someone else's towel, handkerchief or rubbing eyes with dirty hands.
- If in the family somebody is ill with Demodectic blepharitis, hang his towels separately from other family members, make sure that no one would lie on his pillow. Only a conscious attitude of the patient will prevent infecting other members of the family.