Blepharitis is a common inflammation of the eyelids that can sometimes be accompanied by bacterial infection, dry eye symptoms, and skin conditions like rosacea.
Despite being a prevalent condition, it's challenging to fully cure and alleviate the symptoms of blepharitis, which include burning, eyelash crusting, tearing, redness of the eyelid and conjunctiva, itching in the eyes and eyelids, and a foreign body sensation.
Treatment:
The essential and central treatment for blepharitis involves maintaining eyelid hygiene, meaning cleansing the eyelids using Polidin for the eyes, an extremely effective and inexpensive antiseptic solution, or with specialized and more expensive devices like SteriLid. Before cleansing, warm and moist compresses should be applied to the eyelids to soften the crusting on the eyelashes and unblock clogged oil glands. In addition to cleansing, topical or oral medications (pills) might be necessary in some cases. Furthermore, certain patients might benefit from devices containing omega-3 fatty acids, present in fish oil and flaxseed, to enhance meibum secretion from the meibomian glands, which contributes to tear stability and comfort.
If bacterial involvement is suspected, local antibiotic treatment is necessary in addition to eyelid hygiene. Untreated bacterial blepharitis can lead to lash loss, eyelid inversion, and misdirection of lash growth towards the eye.
Another contributing factor to blepharitis is a microscopic mite called Demodex, which also exists in healthy populations and is unclearly associated with eyelid inflammation in some individuals. To diagnose Demodex infestation, an eyelash is plucked and examined under a microscope close to the hair root. Treatment for Demodex is carried out with tea tree oil. It's important to use an eye-specific treatment since the skin formulation can be very irritating to the delicate eye area. Metronidazole, an anti-parasitic agent, can also be effective in treating Demodex.
In cases where local treatment isn't effective, trying a course of oral antibiotics like tetracycline or doxycycline for several months might be considered. These antibiotics have anti-inflammatory properties that improve meibum secretion from blocked meibomian glands. Since they are orally administered antibiotics, they also affect the gut flora and might lead to digestive issues.
In the past year, eye drops called Azasite from the macrolide group (a subfamily of antibiotics including erythromycin) have been developed. However, this medication is not yet available in the country. These antibiotic eye drops have shown efficacy in treating blepharitis in some patients.