Blepharitis is an inflammatory condition of the lid margin and associate eyelash follicles and oil producing glands (meibomian glands). It may be an isolated problem or may be associated with superficial bacterial infections (caused by common skin bacteria – i.e., Staphylococci or Streptococci) or skin conditions such as seborrheic dermatitis or rosacea.
Blepharitis may occur at any age and is typically chronic in nature. It is not unusual for blepharitis to be present without symptoms for months or even years before it becomes a bothersome problem. Burning, irritation and redness of the eyelids are frequent complaints and often seem worse in the morning. Crusting around the eyelashes is often present and is the source for the antiquated term "granulated eyelids".
Inflammation of the small oil glands of the eyelid or the eyelash follicle itself may lead to a tender, localized cyst termed a sty or chalazion. In severe cases, blepharitis can lead to scarring, notching, and thickening of the eyelid margins. Eye lash loss or their growth in the wrong direction are frequent occurrences. When they start rubbing against the cornea, loss of vision due to corneal surface irritation, infection, thinning, or scarring may be seen. Staphylococcal lid margin infections may spread to the adjacent ocular surface (conjunctiva), resulting in conjunctivitis ("pink eye"). Occasionally the corneal surface will become involved with either small punctate erosions or frank ulceration.
Blepharitis is a chronic, annoying and at times aggravating condition for which there is currently no cure. In most cases it may be controlled with relatively safe and simple treatment. Warm compresses combined with cleansing and scrubbing of the eyelid margins are often sufficient to control the symptoms of blepharitis. An antibiotic or antibiotic/steroid combination ointment or drop may be applied to the lid margin and eyelashes or instilled in the eye to promote more rapid control of symptoms and reduce the possibility of corneal scarring. In more severe cases, an oral antibiotic such as tetracycline or doxycycline may be prescribed. It must be emphasized that although no cure may be possible, blepharitis can usually be controlled. Treatment goals include reduction of eye redness and discomfort, and the prevention of corneal changes that can lead to permanent scaring and loss of vision.