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What is blepharitis?
Blepharitis is a chronic inflammation of the eyelids and is considered the most common eye disease. The condition can be difficult to treat and tends to recur, and for this reason is also known as chronic blepharitis. Blepharitis is not contagious and usually does not cause serious damage to the eyes or vision (except in extreme cases that are not treated) but it can cause various symptoms and discomfort. The symptoms of conjunctivitis include redness of the eyes and eyelids, itching, burning and sensation of a foreign body in the eye. Some patients will complain of membranes or secretions from the eyes that stick the eyelashes or eyelids together in the morning. Blepharitis always involves the edge of the eyelid but in some cases may also affect the conjunctiva (the white part of the eye), the cornea (a kind of transparent dome that forms the surface of the eye) and the skin of the eyelids.
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What types of eyelid inflammation are there?
Staphylococcal blepharitis
It is caused by a bacterium called Staphylococcus, a bacterium that naturally exists in the natural flora of our skin and is usually not a harmful factor. The condition usually begins in childhood and continues throughout adult life. This type causes collar-shaped scales on top of the eyelashes, the appearance of crusts and chronic redness of the eyelid margins.
Seborrheic blepharitis
The most common and least severe form of blepharitis. It is not an infection but an abnormal function of the sebaceous glands which causes oily scales to accumulate along the edges of the eyelids. Seborrhea may be part of a general skin condition that also affects other areas of the body. Hormones, nutrition, general physical condition and stress are important factors that affect seborrhea.
Ulcerative blepharitis
A much less common but serious condition characterized by a stiff membrane around the eyelashes. When removing this membrane, small wounds remain that may bleed. The disease can be accompanied by loss of eyelashes, distortion of the eyelid margin and chronic tearing. In severe cases the cornea, the transparent dome at the front of the eye can be inflamed and vision may be impaired.
There is another classification for eyelid inflammation – according to the location of the disease. in the classification
It can be distinguished in three main groups:
Anterior blepharitis
When the inflammation affects the skin around the eyelash follicles. Anterior blepharitis is usually caused by one of two conditions: seborrheic blepharitis or a reaction to staphylococcal bacteria on the skin.
Posterior blepharitis
In patients with posterior eyelid inflammation, the inflammation usually affects the sebaceous glands (called meibomian glands) which are located behind the bases of the eyelashes. These glands can become blocked by scale, debris or bacteria. Therefore, people suffering from various skin conditions such as rosacea or dandruff of the scalp have an increased risk of suffering from posterior eyelid inflammation.
Mixed blepharitis
A condition that combines the two types of eyelid inflammation described - anterior and posterior.
Who is at increased risk of developing eyelid inflammation?
Blepharitis is a very common condition and can appear in anyone and develop at any age, but old age is a risk factor and the phenomenon is observed more frequently among people over 50-60 years of age. The sebaceous glands are responsible for the secretion of the fatty component of the tears, which shields the surface of the eye and prevents increased friction between the eyelid and the cornea, and inhibits the evaporation of tears by creating a fatty buffer between the aqueous component of the tear and the external environment. As you get older, the function of the glands decreases, the contents tend to have a more mushy texture and the glands become blocked. When the fatty component of the tear is damaged, the eye gets a feeling of roughness and dryness.
Causes of eyelid inflammation:
Blepharitis is usually associated with an overgrowth of bacteria that normally live on the edge of the eyelid and at the base of each eyelash. Over time, these bacteria can multiply and form a structure called a biofilm. The biofilm disturbs the natural balance and a hostile environment is obtained. The eyelash mite (called demodex) feeds on the biofilm, which leads to the mite multiplying and worsening the eyelid inflammation. The bacteria that make up the biofilm produce substances that encourage inflammation in the sebaceous glands, the function of the glands is impaired and dryness and ocular discomfort are obtained.
As mentioned, eyelid inflammation is also related to skin problems such as rosacea, eczema, dandruff and psoriasis. Treating and balancing these diseases is a necessary part of the treatment of eyelid inflammation if it exists.
