Global Health Asia-Pacific July 2022 - Page 12

You Ask , They Answer

Q

: What is blepharitis and its tell-tale symptoms ?

A

: Blepharitis is the inflammation of the eyelid margin . A very common cause of eye discomfort and irritation , the condition does not generally threaten your eyesight , but , in severe cases , can lead to complications such as corneal ulcers and permanent corneal scarring . Blepharitis is generally subdivided into anterior and posterior blepharitis . However , there is considerable overlap between the two conditions as both are often present together . Staphylococcal blepharitis is associated with Staphylococcal bacterial infection on the ocular surface while Seborrheic blepharitis is associated with oily and greasy material over the eyelid margin . Both types cause infection and inflammation to the eyelid .
The most common telltale symptoms are burning and gritty sensations with crusting and redness of the eyelid margins . The symptoms often recur with characteristic episodes of remission and exacerbation which are usually worse in the morning . When the condition is associated with dry eye , there may be blurring of vision and mild sensitivity to light .
On examination , there are often hard scales and crusting located at the base of the lashes , and the area covering the surface of the eye ( conjunctiva ) may be chronically red or bloodshot ( hyperaemic ). In long standing cases , there may be scarring and notching of the eyelid margin .

Q

: What are the risks associated with blepharitis ?

A

: Blepharitis can give rise to chronic dry eye due to an imbalance between different components of the tear film , thus allowing increased evaporation of tears . Blepharitis also increases the risk of chalazion or the formation of eyelid cysts . Chalazion may be multiple and recurrent in posterior blepharitis . In more severe cases , it may cause ocular surface disease such as bacterial keratitis ( corneal inflammation ) and atopic keratoconjunctivitis . In chronic cases , it may cause significant long term eye irritation and contact lens intolerance .

Q

: Can people treat it at home or should they always see a doctor ?

A

: Standard therapy aims to control symptoms and inflammatory signs . Eyelid hygiene can be performed easily at home . In severe and / or non-resolving cases , however , a visit to the ophthalmology clinic becomes necessary .

Q

: What are the available treatments ?

A

: Maintaining eyelid hygiene includes several minutes of warm compresses to the eyelid , followed by an eyelid massage and scrub . Warm compresses act to soften the hard scales and the Meibomian secretions from the oil glands along the edge of the eyelids . Eyelid scrubs can help to clear away scales and debris accumulated on the eyelid margin . Eyelid scrubs can be done using a cotton tip with mild detergent , such as baby shampoo or commercially available eyelid wipes .
In the clinic , topical antibiotic ointments may be applied daily for up to one month or until the symptoms resolve for bacterial infection associated blepharitis . Artificial tears may be used to relieve ocular discomfort . Doctors may also prescribe a short course of steroid ointment over the eyelid margin for symptomatic relief in cases with significant inflammation . The minimally effective dose with the shortest duration of use should be used to reduce the risk of increased intraocular pressure and cataracts . Intense Pulsed Light ( IPL ) Therapy over the eyelid may help to resolve Meibomian gland dysfunction . Increased intake of essential fatty acids , specifically omega-3 , may be beneficial for anti-inflammatory processes and may help reduce dry eye symptoms associated with blepharitis .

Q

: Can people prevent this condition ?

A

: People should keep their eyelids clean by maintaining proper lid hygiene . The symptoms can frequently be improved but are rarely eliminated . Patient education and timely medical intervention are key to managing this condition successfully .
Dr Adeline Sia Sien Bing
Dr Adeline Sia Sien Bing is a Consultant Ophthalmologist at Optimax in Malaysia .
10 JULY 2022 GlobalHealthAsiaPacific . com