PATIENT INFORMATION SHEET: INFLAMMATION OF THE EYELIDS IN ADULTS (Blepharitis and Meibomian Gland Dysfunction)
What is Blepharitis?
Blepharitis is a chronic inflammation of the eyelid edges (margins). It is not usually serious, but may become an uncomfortable, irritating problem.
What are the symptoms?
- Sore inflamed eyelid margins. Both eyes are usually affected.
- Gritty, itchy or burning eyes worse in the morning.
- Crusts may develop at the base of eyelashes.
- One or more of the Meibomian Glands of the eyelids may block and fill with an oily fluid.
Symptoms often come and go and can typically flare up from time to time, but you may have long periods without any symptoms.
What is the treatment?
The aim of treatment is to control or manage blepharitis, not to cure it. With regular treatment, symptoms can be eased and then kept to a minimum. If you do not keep up with treatment the inflammation / symptoms tend to recur.
The main treatment is regular eyelid hygiene (see below). Other treatments that may be needed include artificial tear drops and, in some severe cases, antibiotics.
Regular eyelid care
This is the most important part of treatment and prevention of blepharitis. This is a daily routine that consists of three parts – warmth, massage and cleansing.
- Warm compresses
This helps soften the oil in the Meibomian Glands. It can be done with a heated eye mask or a hot flannel (facecloth). Heated eye masks are preferred as they will stay warm for longer.
Eye Mask
There are a number of such eye masks available, which you can buy in pharmacies or from some opticians. The eye masks are warmed in a microwave then placed over your eyes for about five minutes.
Hot flannel
Press on the eyelids gently for 5-10 minutes with a flannel (facecloth) wrung out with very warm water. If the flannel cools, keep re-warming it in the warm water.
- Massage
Massage the eyelids immediately after applying the warmth. Massaging helps to express the oily secretions from the blocked Meibomian Glands.
To massage the eyelids:
With the eyes closed, sweep a finger downwards along the upper eyelid and upwards when moving along the lower eyelid. Massage along the length of the upper and lower eyelids towards the eye. Massage to the end of the eyelids by the lash margin. Repeat this massage action 5 to 10 times over 30 seconds.
Massaging should neither to be too gentle nor too firm. It should be relatively comfortable and you should not press hard enough to actually hurt your eyeball under the closed lids.
- Eyelid Cleaning
After warmth and massage, clean the eyelid margins by any of the following ways:
Cool Boiled Water
Pull the eyelid away from the eye and using a cotton bud that has been dipped in cool boiled water wipe along the edge of the eyelid and remove any crusts, particularly at the base of the eyelashes. You may need to use several cotton buds. Take care not to touch the eye itself.
Medicated Wipes/Solutions
You can buy various medicated wipes or cleaning solutions for blepharitis from some opticians or chemists. Follow the instructions for use on the packaging.
You should do the above routine – warm compresses, massage, clean – at least twice a day until symptoms settle which may take 2 – 4 weeks. When the symptoms have eased, continue this routine once a day, every day, to prevent further flare-ups. If you are prone to blepharitis it is best to think of this as part of your daily routine – just like brushing your teeth. This is the best way to keep symptoms away, or to a minimum.
Artificial tear lubricants
Blepharitis is often associated with dry eyes. Therefore, artificial tear drops may help ease symptoms.
Artificial tears are available as drops, gels and ointment. A range of products are available to purchase over the counter.
Occasionally, some people find one type may irritate. A change to a different preparation may help if the first does not suit.
When to seek medical advice
See your optician (optometrist) or GP if you have persistent symptoms of blepharitis that aren’t being controlled by eyelid care measures.
Most optometry practices across Northern Ireland provide a service for patients who develop a sudden eye problem. Further information on the NI PEARS Scheme can be found here
Contact your optometrist or GP immediately if you have any severe symptoms. If this isn’t possible, visit your nearest emergency department.
Contact your optometrist or GP, or visit your nearest emergency department immediately if you have any of the following symptoms, as they could be a sign of a more serious condition:
- extreme sensitivity to light (photophobia)
- very painful or red eyes
- a deterioration in your vision
Further advice
Diet
Some studies suggest that increasing omega-3 (found in fish oils) and reducing omega-6 (mostly in fast foods), may improve symptoms for people with dry eye syndrome and blepharitis. Omega-3 can be obtained from dietary sources. Alternatively, omega-3 supplements are available to buy from pharmacies and health food shops. Omega-3 supplements are not recommended on health service prescription. Please advise your pharmacist if you are taking other medication.
Further information
The College of Optometrists has a helpful website called ‘Look after your eyes’ which can be found at this link: https://lookafteryoureyes.org/