Blepharitis is the inflammation of the edges of the eyelids. As a rule, blepharitis is a chronic disease that is difficult to treat. Anatomically distinguish:
Anterior marginal blepharitis - a lesion of only the ciliary edge of the eyelids. Posterior marginal blepharitis - accompanied by inflammation of the meibomian glands in the thickness of the eyelid, the conjunctiva and the cornea can be involved in the pathological process
In fact, in most clinical cases, both anterior and posterior marginal blepharitis is observed, that is, the eyelid is inflamed throughout its thickness.
Causes of inflammation of the eyelids
There are many causes of inflammation of the eyelids. Blepharitis can be an independent disease, for example, when the eyelids are affected by fungi, mites, bacteria, and the manifestation of any pathological process: chronic infectious and allergic diseases, hypovitaminosis (lack of vitamins), anemia, tuberculosis, diabetes, diseases of the digestive tract , Gastritis), teeth, nasopharynx, etc.
Blepharitis often occurs with farsightedness and astigmatism, and can also develop with a pronounced "dry eye" syndrome.
Common symptoms and peculiarities of individual clinical forms of blepharitis
Manifestations of blepharitis can be: redness and swelling of the eyelids, burning, itching, scales and crusts on the skin of the eyelids, stuck eyelashes, loss and incorrect growth of eyelashes, lacrimation, eyes become sensitive to bright light, quickly get tired even with a small visual load.
The following clinical forms are distinguished:
Scaly, or seborrhoeic, blepharitis is often combined with seborrheic dermatitis of the scalp, eyebrows, behind-eye areas, characterized by reddening and thickening of the edges of the eyelids with the formation between the eyelashes of scales tightly attached to the skin. When removing scales, the skin remains intact and does not bleed. At the edges of the eyelids, you can see yellowish crusts - this is the dried off sebaceous glands. Over time, the swelling of the edges of the eyelids increases, the eyelids cease to adhere to the eyeball, lacrimation appears. Sometimes the process extends to the conjunctiva and develops blepharoconjunctivitis. With a prolonged course of scaly blepharitis, partial alopecia occurs (loss of eyelashes), an eversion of the eyelid can form.
Ulcerative blepharitis is characterized by purulent inflammation of the hair lobes of the eyelashes, purulent crusts are formed, upon removal of which bleeding ulcers with a purulent coating are formed, later on their place scars are formed. Since the process involves hair follicles, eyelashes fall out. In some cases, may develop a madarose - a complete lack of eyelashes. Cicatricial changes can lead to incorrect growth of eyelashes and eyelid deformity - a turn or a twist.
Demodekozny blepharitis occurs when the eyelid mites Demodex. Initially, patients are disturbed by severe itching, especially after sleep, a sticky discharge occurs, then a pronounced inflammation of the ciliary edges of the eyelids develops, which become thickened, reddened. The secret of the sebaceous glands and cell particles form a "collar", a "muffle" at the base of the eyelashes. Dry dried out accumulates in the form of scales between eyelashes. Ticks are found at the root of the removed eyelashes during microscopic examination.
Allergic blepharitis, as a rule, is combined with an allergic inflammation of the conjunctiva. The reason is an increased sensitivity to any substance: drugs, cosmetics, dust, wool, feathers, fluff, etc. Allergic blepharitis can be both acute and chronic. The patient is disturbed by: edema of the eyelids, itching, lacrimation, mucous discharge, pain in the eyes. Usually both eyes are affected.
Diagnosis of blepharitis is based on biomicroscopy - examination of eyelids and eyelashes with a slit lamp. To confirm the diagnosis of demodectic blepharitis, it is necessary to examine the newly removed eyelashes under a microscope for the purpose of detecting Demodex mites.
Treatment of blepharitis is long. The main task is to eliminate the cause of blepharitis and local symptomatic treatment.
Careful hygiene of the eyelids is the main component of the treatment of blepharitis, regardless of the cause that caused it. Regardless of the cause that caused blepharitis, a thorough hygiene of the eyelids is necessary. In the modern pharmaceutical market a large number of special lotions and gels for hygienic treatment of the eyelids are presented. Additionally, based on the cause of the disease, drops or ointments are prescribed.
In case of allergic blepharitis, it is necessary to try and fix and eliminate the allergen. You may need to abandon your favorite cosmetic remedy or change the solution for contact lenses. Locally appointed antiallergic drops and, if necessary, corticosteroid eye ointments to lubricate the edges of the eyelids.
The treatment of seborrheic blepharitis is based on daily hygienic treatment of the eyelids. Eye hydrocortisone ointment is prescribed by the course to eliminate acute symptoms. Since scaly blepharitis often has dry eye syndrome, moisturizing drops are recommended.
Ulcerative blepharitis, as a rule, is caused by bacteria, therefore, in addition to hygienic treatment of the eyelids with removal of crusts and eyelash epilation on the ulcerated surface, it is necessary to use drops and ointments containing an antibiotic.
When demodectic blepharitis is the main antitussive treatment. The edges of the eyelids are treated with alcohol solutions, while they tend to degrease the skin and completely release the eyelashes from detachable, crusts, scales, along with which the parasites and products of their vital activity are removed. Then, on the edges of the eyelids, various ophthalmic ointments are applied, which have an antimicrobial and antiparasitic effect, disrupt the life cycle of the mites. Treatment is long - 1,5-2 months.
With blepharitis, accompanied by blockage and inflammation of the meibomian glands, a special eyelid massage is prescribed, which is first performed by the doctor, and then by the patient himself.
Considering that almost all patients with blepharitis have any concomitant diseases, general treatment is necessary: correction of nutrition, vitamin therapy, increased immunity, elimination of concomitant pathology.
Acute blepharitis easily passes into a chronic form, so it requires specialist supervision and careful performance of appointments.
In case of acute or chronic inflammation of the eyelids, you should consult a doctor. Do not self-medicate. This can be not only inefficient, but also dangerous because of possible complications. The expert will help to establish the cause of blepharitis, will show how to properly perform hygienic treatment and massage the eyelids, will prescribe the necessary treatment.
Blepharitis easily flows into a chronic form with non-observance of the rules of eyelid hygiene and improper use of medicines, therefore it requires monitoring by a specialist and careful follow-up by the patient of the doctor's recommendations.