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Blepharitis

Blepharitis is a long-term, chronic inflammation of the eyelid margins, where the hair follicles and sebaceous glands are inflamed.

Complaints

Blepharitis is a nuisance, but an innocent condition that can cause many complaints. You may suffer from irritation, itching or burning of the eyes and sticking eyelids. The eyes can also feel tired. Often small crusts form between the eye hairs.

There are two forms of blepharitis: anterior blepharitis and posterior blepharitis. You can suffer from one or both forms.

Anterior blepharitis

Your eyelid margins are inflamed in anterior blepharitis. You often suffer from skin flakes and scabs between the eyelashes. You may also suffer from red and irritated eyelid margins.

Posterior blepharitis

In posterior blepharitis (also called Meibomitis) the drainage channels of the sebaceous glands of Meibom are blocked. This is not always visible on the outside of your eyelids. You may experience symptoms such as itching, tears, blurred vision, irritation and burning. Posterior blepharitis leads to a reduced release of fat to the tear film. This is called Meibomiam Gland Dysfunction (MGD).

Dry eyes

In your eyelid margins are glands that produce substances that are important for the stability of the layer of tears on your eye. If you have blepharitis and the eyelid edges are inflamed, these glands do not work well. The result is that you can suffer from dry eyes.

Causes of Blepharitis

Blepharitis is caused by a chronic bacterial infection of the hair follicles and the sebaceous glands in the eyelid margins. The bacteria make substances that irritate the eye and the inflamed sebaceous glands make too much or too little sebum, which can cause burning dry eyes.

The precise cause of the ignition is unknown. Blepharitis is more common in people with skin conditions such as eczema, acne and rosacea.

Treatment

Blepharitis is a chronic, persistent condition that you must continue to treat. If you stop treatment, the complaints often return.

Warm eye compresses

Warm eye compresses ensure that the sebum in the sebaceous glands and the crusts between the lashes become softer, so that they are easier to remove. The duration of heating is very important, because it takes 10 minutes before the sebum melts in the eyelids and therefore easily comes out of the sebaceous gland.

Heat a washcloth or handkerchief with warm water. First test on the back of the hand if the cloth is not too warm. Place the warm, wet cloth on the closed eyes and leave them on the eyes for 10 minutes . It is important that the cloth remains sufficiently warm, so the cloth must be warmed up again with warm water. Do this preferably twice a day before you start the treatment.

You start each treatment first with a warm eye dressing. You then treat anterior blepharitis by cleansing your eyelid margins, with posterior blepharitis you must empty the sebaceous glands. In both cases you need to brush the eyelid margin after the treatment with the warm compresses.

Brushing the eyelid margins (eyelid hygiene) in anterior blepharitis

The most important thing in treating anterior blepharitis is to brush the eyelid edges twice a day. This ensures that the sebum and crusts are removed, which will reduce the symptoms. You can do this with special means such as Blephasol (without a prescription available at your pharmacy). You can also make your own solution with diluted baby shampoo.

What do you need to make a solution with baby shampoo yourself:

  • Glass of hot tap water
  • 2 to 3 drops of baby shampoo
  • Cotton sticks or gauze

Mix the drops of baby shampoo with the hot tap water. Soak the swab or the gauze in the diluted solution. You have to brush the eyelid edge when implanting the eyelash hairs. You brush from the outside towards the nose with massaging movements. Make sure that you do not damage your eye. When brushing the lower eyelid, pull down the eyelid edge and brush the eyelid edge upwards when brushing the upper eyelid. Brush until the skin flakes and the fat of the eyelid edges are gone. Brush your eyes preferably twice a day: after waking up and before bedtime. If you find it difficult to brush yourself, you can also have someone else do this.

Emptying the sebaceous glands in posterior blepharitis

You treat posterior blepharitis by emptying the sebaceous glands after the warm eye compress. You take a dry cotton swab. With the cotton swab you make massaging vertical movements towards the eyelid edge. Apply enough pressure to empty the sebaceous glands. After that you also rub the edge of the eyelid horizontal, for optimal cleaning. Be careful not to damage your eye. If you find it difficult to do this yourself, you can also have someone else do this. For the best results, carry out the treatment twice a day.

Cleaning the eyelid in Blepharitis

Eye ointment

If the blepharitis is persistent, your ophthalmologist can prescribe an eye ointment with antibiotics or with antibiotics and corticosteroids. This ointment should be applied twice a day on the eyelid edges, after brushing. This ointment is prescribed for a period of one to several weeks, after which you have to stop the ointment again. Your doctor may decide together with you that you can repeat the treatment with eye ointment if necessary.

Important to know

Blepharitis is a chronic condition that you must continue to treat. The complaints do not always go completely despite the treatment. Furthermore, periods without complaints can alternate with periods in which complaints increase.

When the symptoms are gone and you stop brushing the eyelids, the symptoms may return. It is therefore important to maintain the treatment (eyelids brush daily and always do warm compresses), even when the symptoms are gone. Because the eyes may look red after cleaning, it is best to do it in the evening, before you go to sleep. Try to do the cleaning at least 3 times a week, to keep it under control. And take your time to do the cleaning, it takes at least 15 minutes (10 minutes of warm compresses and 5 minutes to massage both eyes).

Do not use eye makeup when the eyelid edges are inflamed.

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