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Blepharitis is a chronic inflammation of the eye lids and is one of the most common problems we see in the office. Basically, there are two main causes:
- STAPHYLOCOCCUS. (Staph) This is a bacterial infection of the lids that commonly begins in childhood and continues throughout adulthood. It produces scales, matter, and chronic redness of the lid margin. Staph may also cause ulceration of the lids, crusts, broken eye lashes and characteristic collar scales on the lashes. Also seen are dilated blood vessels, loss of lashes, sties, and chalazia. If left untreated the cornea and conjunctiva can sometimes become infected and scarred.
Treatment is directed at keeping the lids immaculately clean by scrubbing with Q-Tips and a mild baby shampoo. Once under control, lid scrubs may be decreased and used only intermittently, depending on the severity of the disease. Antibiotic drops and ointments are also helpful in controlling the condition. Only in recalcitrant cases are oral antibiotics necessary. Sometimes cortisone drops relieve the bothersome symptoms of irritated, red lids. Hot packs help dilate the blood vessels and facilitate the healing powers in the bloodstream. They also help open and clean out the infected pores. Even with the best of treatment, Staph Blepharitis can be a continuing nuisance and a difficult disorder to completely eliminate.
- SEBORRHEA. This is a commonly seen condition of the eyelids as well. The lids accumulate greasy, waxy scales along their margins. The glands of the lid produce abnormal quantities and qualities of tear film…a film that normally coats, protects and lubricates the eyes. Seborrhea of the lids may be just part of the overall skin disease that affects areas of the chest, back scalp and behind the ears.
Treatment is again directed at lid cleanliness with washes, rinses, and hot packs, as outlined above. Prescription eye drops are also helpful. The other affected areas of the body should also be treated with appropriate shampoos and medicines. Many factors contribute to this disease, including hormones, nutrition, general physical condition, and stress.
Separating these two forms of BLEPHARITIS from each other is sometimes very difficult, as they frequently appear together. The important thing to remember is that both can almost always be controlled with vigorous treatments and good patient cooperation.