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What is Blepharitis?

Blepharitis is an inflammatory condition affecting the eye lid edges. It is common and cannot usually be completed cured by a single course of treatment. However, you can learn to manage this condition so that you suffer minimal discomfort and irritation. There are 2 broad subtypes "Anterior" and "Posterior" although the two commonly co-exist.


Symptoms are very variable, from none but with un-sightly crusting of the eyelashes, to redness and thickening of the eye-lid margins. It often co-exists with dry eye syndrome, and can make the symptoms of this (grittiness, soreness, dryness) worse.


Once the condition has been diagnosed you will be advised to undertake "lid hygiene".  One way to do this is as follows; buy some baby shampoo and dilute it one part in ten parts of boiled water. There are alternative proprietary formulations that can be used. Use this with a cotton bud to shampoo the eye lashes of the upper and lower lids on each side. The cotton bud must physically dislodge the scales at the base of the eye lashes. This should be done twice a day for one week and then daily for one week, and then twice a week indefinitely. Alternatively, you may wish to purchase a proprietary product for lid hygiene called "BLEPHACLEAN" from your chemist and follow the instructions in the pack.

It is likely that cleaning the eye lids in this way will initially make the discomfort worse. You are advised however, to persevere as your eyes will rapidly become more comfortable if you continue with the treatment.

IF you have been provided with some eye ointment, it is important that this is not put on top of the crusts at the base of the eye lashes, but is only put onto the eye lids after the crusts have been physically removed as explained above.

You may be advised to do hot bathing and massage to treat the Meibomian glands. The hot bathing melts the waxy secretions and the massage expresses them to restore normal function. To do this, use hot (not warm, not scalding!) water and a face flannel to warm the eyes-lids with 3-4 applications for 5-10 seconds. Then press firmly on the eye-lid adjacent to the lash-line. You have to press very firmly; as hard as is possible without discomfort, to express the Meibomian gland secretions. This should be done twice a day for one week, then once a day for one week, then twice a week forever. Alternatively, heating devices can be obtained from The EyeBag Company, although massage after use remains a very important part of the treatment.

If you have been prescribed tablets, please note that although these are antibiotics, they are at a dose too low to act as effective antibacterials; their role is to change the lipid (fat) metabolism in the eyelid glands. The conventional treatment period is for 3 months, but newer drugs may allow a successful course of treatment in only 3 days.

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