Do you suffer from sore, red, itchy or swollen eyelids? Do your eyes feel gritty or like there’s something in them?
You could be experiencing a buildup of bacteria and oily flakes on your eyelash line. This bacteria causes inflammation of the eyelid margin which can lead to ocular irritation and further complications. This is known as Anterior Blepharitis.
Over time, this bacteria can cause clogging and inflammation of the Meibomian (oil) glands within the eyelids. This progression of blepharitis is called Posterior Blepharitis and leads to symptoms of dry eye disease. In fact, Posterior Blepharitis is found in 85% of those suffering from dry eyes.
So, who gets blepharitis? It’s commonly associated with ocular rosacea, seborrheic dermatitis (oily skin), psoriasis or contact lens intolerance. Although blepharitis and dry eye disease can occur in isolation, the two typically occur simultaneously, and are likely part of a single chronic eye condition.
An overgrowth of bacteria on the eyelid margin can lead to the formation of a biofilm. This biofilm produces and release exotoxins that cause inflammation of the eyelid margins and Meibomian glands within the eyelids. When these Meibomian glands become clogged and inflamed, less oily tears are produced. Without this oil, the watery surface of the tears is quick to evaporate, leading to an overall decreased number of tears on the ocular surface.
Our tears contain natural antibodies and are used to wash away any debris that may enter the eye. With a smaller number of tears, it’s easier for bacteria to grow and the more significant the inflammation will become.
Chronic inflammation of the Meibomian glands can lead to atrophy, and at that point, function cannot be regained.
How is it best to treat blepharitis? Blepharitis is a chronic condition that must be consistently treated. Following are some of the at-home as well as in-office treatment options available.
Eyelid Scrubs
Daily eyelid scrubs can help to remove the biofilm buildup, excess bacteria, dirt, and oils from the lid margins. Our recommended brand is OCuSOFT. These pre-moistened pads can be used to scrub eyelashes and eyelid margin and do not need to be rinsed off. In the beginning of treatment, eyelid scrubs are to be used two times daily for one week. Once blepharitis is under control, these pads are to be used once daily.
Warm Compresses
Warm compresses are designed to heat the oily Meibomian glands in the eyelid to a specific temperature which melts the thick, oily substance that is clogging these glands, helping to clear the blockage. This helps keep the Meibomian glands functioning properly. Our recommended brand is Bruder Dry Eye Hydrating Compress mask. I’s best to use the mask 2 times a day for five minutes each followed by gently massaging the eyelid margin for one week. Once blepharitis is under control the mask should be used once daily for 5 minutes followed by gently massaging the eyelid margin.
Omega-3 Supplements
PRN Dry Eye Omega Benefits is a custom formula based on research to provide relief for dry eye and to help keep the Meibomian glands healthy and functioning properly. The daily dosing provides 2-3 grams of Omega-3’s and is triglyceride based. The recommended dosing is 2 pills taken two times a day (4 pills total daily). The full benefit of these pills is not achieved until three months of continuous use.
Artificial Tears
These drops are formulated specifically for those suffering from Meibomian gland dysfunction (MGD). These are commonly used for immediate although temporary relief of symptoms. The brand and usage should be recommended for your specific situation.
Doxycycline
While the antibiotic doxycycline has obvious antimicrobial properties, it has also been shown to have strong anti-inflammatory properties as well. These pills work to stop the compounds in your body that cause inflammation and help to clear out the congested oil glands (Meibomian glands). Courses of doxycycline may be beneficial in providing symptomatic relief in those with rosacea and blepharitis/MGD.
Antibiotic Eye Drops/Ointment
Antibiotic ointment can be used at night to decrease the number of bacteria present on the eyelid margin while also keeping your eyes lubricated as you sleep. Removing this bacteria helps increase the oil layer, remove the biofilm, and reduce inflammation.
In-Office Debridement
Our in-office lid scrub device can be used to remove excess scruff and dandruff from the eyelid surface. This helps to reduce inflammation and can improve the success of your Meibomian gland treatment. This process is typically performed before MiBo Flo treatments.
In-Office MiBo Flo Treatments
This new technology treatment is an in-office procedure that is designed to clear out the Meibomian glands more thoroughly than any at-home treatment. This procedure is typically performed multiple times within the first month and then anywhere from monthly to quarterly in order to receive the full efficacy of treatment.
As with many eye conditions, blepharitis can have different causes and a multitude of symptoms. At our Dry Eye Institute, we develop individualized treatments plans which are based on your symptoms and diagnosis. There’s no need to continue to suffer!