BLEPHARITIS

Blepharitis is a common condition that causes inflammation of the eyelids. It can affect the inside or outside of the eyelids. The condition can be difficult to manage because it tends to recur.


What is the treatment for blepharitis?


There is no one-off cure, as the inflammation tends to recur if you do not keep up with treatment. However, with regular treatment, symptoms can usually be eased and then kept to a minimum and prevented from flaring up. The main treatment is regular eyelid hygiene.Other treatments that may be needed include antibiotics, and treatment of associated conditions.


Regular eyelid hygiene


This is the most important part of treatment and prevention. The aim is to soothe the Eyelids ‘unplug’ any blocked meibomian glands and clear out any stagnant oily secretions from these glands, and to clean the eyelids of debris. This is a daily routine that consists of three parts – warmth, massage and cleaning. Remove any contact lenses before the following routine.

Warmth


The purpose of warmth is to soften the skin and any crusts attached to the eyelids. But also, to allow the oily secretions made by the meibomian glands to flow more freely. As with any type of oil, warming the oil made by the meibomian glands will make the oil more ‘runny’. Therefore, warmth helps to ‘unplug’ any blocked glands and allow the oily secretions to flow more readily. Warmth applied to the eyelids for about ten minutes is thought to do this. This can be done very effectively with The Eye Bag™. This is a specially designed heat bag, which you place over your eyes for about ten minutes. The eyebag doesn’t get wet so it will not harbour bacteria. Put the EyeBag in a clean microwaveable dish before placing it inside your microwave oven. Place the EyeBag in the microwave oven on full power for the following times depending on your microwave wattage: 650 watt: 60 seconds, 750 watt: 45 seconds, 900 watt: 30 seconds. These times are guidelines only and you may need to adjust the time and duration of heating depending upon your microwave wattage and also on the age of your EyeBag. Older EyeBags will take longer to heat and will retain the heat for shorter periods of time. You should hold the EyeBag by its tips and invert the bag so that the flax seeds are mixed thoroughly. You should test the EyeBag for temperature to make sure it is comfortably warm. You should then recline or lie in a comfortable position and tilt your face so that you would be looking directly up to the ceiling. Some people will prefer the feeling of silk against their face whilst others will prefer the feeling of the suedex. Once you are in a comfortable position, place the EyeBag over your face and mould it to your facial shape so that the bridge of the nose the both upper and lower eyelids are covered by the EyeBag. You should feel general warmth from the eyebrows to the cheeks. This indicates that the EyeBag warmth is being delivered to your eyes. It is important to keep your eyes closed during this treatment as opening the eyelids whilst they EyeBag is in place could lead to a scratch or abrasion of the front of the open eye. You can simply lie down and relax for ten minutes with the bag placed over your eyes. (A hot flannel usually cools too quickly.)

EYELID MASSAGE AND CLEANING


Massage


Massage the eyelids immediately after applying the warmth. Massaging helps to push out the oily fluid from the tiny meibomian glands. To massage the eyelids use your index or middle finger and sweep the pad (fingertip) of that finger from the inner corner of the eye along the eyelid to the outer corner of the eye. Start with the upper lid. Put the finger pad in the corner of the eye next to the nose, just resting on the eyelid above the lashes. Then sweep the finger gently but firmly along the eyelid to the outer end. Repeat this with the lower lid, placing the pad of the finger just below the lashes in the corner of the eye and sweeping outwards towards the temple. Repeat this sweeping massage action 5 to 10 times over about 30 seconds Immediately following the warming. Massaging should neither to be too gentle nor too firm. It should be relatively comfortable and you should not press hard enough to actually hurt your eyeball under the closed lids. Always massage with the eyes shut.


Cleaning


After warmth and massage, clean the eyelids. Using special eyelid scrubs can do this. In particular, try to clean off any crusts at the base of the eyelids. Brush the lids in “from the nose to the ear”. Do both upper and lower lids. You should do the above routine – warmth, massage, clean – at least twice a day until symptoms settle. When the symptoms have eased, keep doing this routine once a day, every day, to prevent further flare-ups. If you are prone to blepharitis it is best to think of this as part of your daily routine – just like brushing your teeth. This is the best way to keep symptoms away, or to a minimum.

Please watch the short Video below

Other Lid conditions


Chalazion


A chalazion, also known as a meibomian cyst, is a common condition affecting the eyelid. The fluid-filled swelling (cyst) is usually felt as a small lump. Occasionally, it can become infected. It is caused by blockage of a gland in the eyelid. If it is causing problems and does not settle on its own, it can be removed with a small operation.A chalazion is a small (2-8 mm) fluid-filled swelling (cyst) in the eyelid. It is common and sometimes called a meibomian cyst or tarsal cyst. A chalazion is more common on the upper eyelid and can affect both eyes. It is not the same as a stye.


What causes a chalazion?


There are tiny glands just under the inner surface of the eyelid. These make an oily fluid to help lubricate the eye. If the gland gets blocked then the fluid cannot escape and it may expand into a fluid-filled swelling (cyst). A chalazion is not normally infected. Over time, inflammation causes a nodule (or granuloma) to form. This is a firm, more solid lump that remains for a long time (is chronic). This lump is the chalazion and can occur following an internal stye (hordeolum)


What are the symptoms of a chalazion?


• The usual symptom is a small lump which develops on an eyelid. It might look unsightly.

• Sometimes it causes mild pain or irritation, particularly if it has just started – this usually settles.

• Occasionally, it gets infected. It then becomes more swollen and painful.

• Sight is not affected. Rarely, it can become so big that it presses on the eyeball and distorts vision.What is the treatment for a chalazion?• No treatment may be advised at first. Between 1 in 4 and 1 in 2 people get better without any treatment. It can take quite a long time, between two and six months or more to resolve. However, if it is not causing you any problems, it is probably best to just to watch and wait.

• Hot compresses help to ease discomfort. Hold a clean flannel that has been in hot water gently but firmly against the closed eye. Do this for 5-10 minutes, 3-4 times a day. Sometimes this warmth and slight pressure is enough to soften the contents of the fluid-filled swelling (cyst), helping it drain more easily. (The water should be hot, but comfortable and not scalding.)

• Massage of the cyst after using a hot compress can encourage the cyst to drain. Do this gently, with a clean finger or cotton bud, in the direction of the eyelashes.• Cleaning the eyelid twice per day removes grease and grime that may contribute to cysts forming. Blephasol is ideal.

• A small operation is an option if it does not go, or if it causes troublesome symptoms. Your GP can refer you to an eye surgeon (ophthalmologist) for this. The operation is done under local anaesthetic. The eyelid is numbed. A small cut is then made on the inside of the eyelid to release the contents of the cyst. It is a minor procedure.


Note: antibiotic ointments, drops and medicines are not recommended as they do not make any difference – the contents of the cyst are infection-free (sterile).