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Why does recurring blepharitis cause so much pain and suffering? Many eye doctors recommend treating blepharitis with a hot compress and eyelid cleanser. But not the underlying cause of blepharitis is dry eyes.

Why TheraLife ?

The reason being dry eyes, blepharitis and MGD are all connected. TheraLife is an oral dry eye treatment that relieves dry eyes from inside out. TheraLife promotes and restores normal cell functions in your whole body, including the eyes.  TheraLife Blepharitis Starter Kit treats dry eyes, blepharitis, and MGD simultaneously for complete recovery.

To learn more about why TheraLife works.  

What is Blepharitis

Blepharitis is identified as inflamed eyelids caused such as irritations and allergies, infections, and insect bites. It can range from a mild, chronic condition due to allergies or severe form with ulcerated eyelids and even damage to the eyes or eyelids.

Behind the eyelids and eyelashes are several glands. The Meibomian glands secrete a fatty substance called meibum that spreads (via blinking) over the eye’s surface and slows the evaporation of tears. Tear-secreting glands also lie behind the eyelids.

Blepharitis is identified by the presence of “greasy scales” between the eyelashes and redness on the lid around the eyelashes caused by the body’s immune response (increased blood flow). Sometimes tiny veins expand and are noticeable (telangiectasia); the eyelid can become swollen.

Dysfunctioning of the meibomian gland may cause or contribute to blepharitis in the front or back of the eyelid. Blepharitis may occur as acute (often sudden onset) or chronic (ongoing).

  1. Anterior blepharitisis found on the front and outside of the eyelid along the line of eyelashes. Inflammation is most commonly caused by bacteria such as (Staphylococcus) and scalp dandruff (seborrheic dermatitis). Increased meibomian gland activity may also occur.2
  2. Posterior blepharitisis found on the innermost part of the eyelid that touches the eyeball. It is caused by dysfunctioning meibomian glands. Among other causes, two skin disorders can cause posterior blepharitis: scalp dandruff and acne rosacea leading to red and inflamed skin.3

Symptoms

Symptoms are redness, itching, scaling, swelling crusting of the eyelashes. Posterior blepharitis causes dry eyes. It may be accompanied by styes and chalazia. Tiny veins may be swollen enough to be visible.

Blepharitis is also linked to acne rosacea.

Causes

Bacteria, dandruff, and fungi are common causes of blepharitis. But what may be more important is that the presence of these toxins that change the healthy environment of the eyelid and produce pro-inflammatory cytokines, toxins, and free radicals.4

1.Anterior

Bacteria can cause blepharitis, especially staphylococcus and bacterium acne.

Scalp dandruff (seborrheic dermatitis) or a mix of bacteria and dandruff is also very common. This form of blepharitis allows increased growth of Malassezia yeasts that live in the skin’s sebum oil. This type of blepharitis is not as severe as a staph infection, but the eyelids will look greasy and scaly. The patient may also have dandruff, acne, or eczema.

Fungi have also been found to be present with blepharitis and may be a cause. These include penicillium, candida, and trichophyton.5 Researchers have also identified pityrosporum yeasts.6

Demodex mites have also been found in blepharitis eyelids.7 The presence of mites or microbes on the eyelids does not prove that they caused the condition. Instead, all that can be said is that they found the changed eyelid habitat more hospitable than that of a healthy eyelid. In fact, in such cases, treatment with antibiotics or steroids may change the microbial life of the healthy eyelid in favor of specific antibiotic-resistant strains.

Irritation from insect bites, scratches, or infections.

Allergies from pollen or environmental pollutants.

2. Posterior

Meibomian gland dysfunction is the most common cause of posterior blepharitis.

Skin conditions such as rosacea and scalp dandruff can also cause posterior blepharitis.

Conventional Treatment

Conventional treatment depends on the specific type and severity. Mild symptoms may only require warm soaking and daily lid hygiene. Diluted baby shampoo may be used for cleansing the lids. Other varieties may require antibiotics and/or cortisone cream, or even oral antibiotics, any of which should only be used under medical supervision.

Home Remedies

  •       Avoid rubbing your eyes.
  •       Apply a warm, wet washclothas a compress to the affected area and hold it in place until cool. Repeat this 3 to 4 times a day.
  •       Use a commercial lid “scrub”or baby shampoo on a cotton swab to wash your lids. We provide sterile, preservative- and fragrance-free LidHygenix is a gentle foam solution to cleanse the eyelid.
  •       Castor oil. (fresh and from the health food store) – place a small bet on a q-tip and apply to the inner lower lid margin.
  •       Honey. Same application as with castor oil. Thin with sterile spring water to reduce stinging. This can be done while doing the “Sunning” eye exercise (see free eye exercises) because it really brings tears. Honey is antibiotic, anti-fungal, and antiviral.
  •       Salt and baking soda. 1/4 teaspoon of salt + 1/4 teaspoon baking soda in 1/2 cup of warm water boiled. Dip finger in the mixture and rub on eyelid margins with eyes closed. Once in the morning and once at night before bed.
  •       Massage protocol. One study reports beneficial results with a specific massage protocol for blepharitis1, as follows:

 During a comfortable, warm shower – close the eyelid(s) gently massage the upper lid down and the lower lid upward for 30 seconds.

 After a shower, use a warm water-moistened Q-tip to gently but firmly scrub all eyelid edges- where the lashes grow (not the red inside of the eyelid). Be careful to not touch the sensitive cornea.

 Lower lid:

          1. Hold the Q-tip in your hand, close enough to the tip for stability, perhaps an inch or two from the end.
          2. Use the index finger of the other hand to gently pull down the skin below your eye to turn out the eyelid so that it is further from the sensitive cornea.
          3. Scrub in small sections (1/5 of the eyelid length) for 3 seconds each across the edge.

 Upper lid: Hold and turn out the upper eyelid by turning away from the sensitive surface of the cornea. Using two fingers to pull up the eyelid can work well.

Although the underlying physiological cause may be unique, there may be similarities in nutrition, diet, and lifestyle.

References

  1. Report of the TFOS Workshop on Meibomian Gland Dysfunction. Invest Ophthalmol Vis Sci.Special Issue. 2011;52(4):1917-2085. Available at: iovs.org/content/52/4.toc.
  2. Macsai MS. Trans Am Ophthalmol Soc. 2008;106:336-356.
  3. Back EE et al. Antimicrob Agents Chemother.2012;56(2):739-742.
  4. Utine CA. Clin Ophthalmol. 2011;5:801-809.
  5. 5 Perry HD et al. 2006;25(2):171-175.
  6. Christopher MP. Diagnosis and management of blepharitis: an optometrist’s perspective. Dove press journal: clinical optometry 2016; 71-78.
  7. G Nageswar R, SilpaS, Sweta P, HumaR, Bhaskar T, Arttatrana P. Prevalence of ocular morbidity among children aged 17 years or younger in eastern india. Clinical Ophthalmology 2018; 12:1645-1652.
  8. Ajith KD, Ajoy BN. Prevalence of ocular morbidities among school children in a rural block of cachar, Assam. Journal of Evolution of Medical and Dental Sciences 2017; 6:4124-4127.
  9. Vasantha M, Siva SR. Morbidity pattern of geriatric population attending rural community health centre, south India. Akshantala Journal of Research in Preventive and Social Medicine 2017; 1:12-16.
  10. Ann MT, Alexander J, Leelamoni K, Natasha R, Swati P, Harsha. Prevalence and Predictors of Ocular morbidity among Primary School Children of Urban Kerala. National Journal of Research in Community Medicine 2015; 4:268-277.
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  16. Mihaela AI, ConstantinC, MihaiL, Daniela L, Mircea T, Simona RG, Alexandra B, Carolina C, Monica N, Sabina AZ, Daniel B. Current and future applications of confocal laser scanning microscopy imaging in skin oncology (Review). ONCOLOGY LETTERS 2019; 17: 4102-4111.
  17. Justin S et al. Randomised double masked trial of eyelid cleansing treatment for blepharitis. The Ocular Surface 2018; 16:77-88.
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  21. Giacomo DB, Agostino SV. Oral azithromycin and oral doxycycline for the treatment of Meibomian gland dysfunction: A 9‑month comparative case series. Indian Journal of Ophthalmology 2019:67:464-470.
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  23. Samir SS. Topical Tacrolimus in anterior segment inflammatory disorders. Eye and Vision 2017; 4:1-7.
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