Blepharitis

Diagnosis

Blepharitis does not have a single definitive test. Instead, your eye care provider may follow these steps to determine if you have blepharitis and identify its specific type:

• Eye examination: The type and severity of blepharitis can be determined by observing the appearance of your eyelids, as well as assessing the intensity of reddening, discharge, and swelling. To aid in this examination, your doctor may use a specialized magnifying instrument to carefully inspect your eyelids and eyes.
• Tear test: A sample of tears can be used to evaluate whether dry eye is a contributing factor.
• Swabbing skin for testing: A swab of eyelid secretion, oil, or crust may be sent to a lab. This sample can be tested for bacteria, fungus, and allergic symptoms. It can determine what type of bacteria is present and in what quantity.
• Eyelid biopsy: In rare cases, a biopsy may be necessary to rule out skin cancer or detect any abnormal cells, as determined by your healthcare provider. During this procedure, your eyelid will be numbed using a local anesthetic, and a needle will be used to extract a sample of cells for microscopic examination. While there may be some bruising, the risk of scarring is minimal.

Treatment

If you suspect you have blepharitis, you can try the following self-care tips to alleviate the symptoms:

• Avoid Eye Makeup: To reduce irritation, refrain from using eye makeup until the inflammation is under control.
• Use Warm Compresses: Begin by taking a clean washcloth and soaking it in comfortably warm water. Make sure to wring out any excess water, and then gently place the cloth over your closed eyelids. For best results, maintain the cloth’s warmth by reapplying as needed. With time, the crusts will soften, making it easier to remove oily debris.
• Use Lid Scrubs: Over-the-counter lid scrubs are available in various forms such as sprays, foams, or individually wrapped towelettes, often containing hypochlorous acid. These scrubs are effective in reducing dandruff on your eyelashes and decreasing bacterial buildup on the skin around your eyes.

Self-care measures are typically effective in managing most cases of blepharitis. However, if self-care proves insufficient, a doctor may recommend prescription treatments, which can include:

• Medications for infection: Topical antibiotics, available in the form of eye drops, creams, or ointments, have demonstrated effectiveness in alleviating symptoms and treating bacterial infections of the eyelids. However, if there is no improvement with the use of these topical treatments, a potential next step recommended by your doctor could be the use of oral antibiotics.
• Medications in controlling inflammation: Steroid eye drops or ointments are commonly employed for this purpose, especially in cases where other therapies have proven ineffective. Doctors may prescribe a combination of antibiotic and anti-inflammatory drugs as an alternative approach.
• Medications affecting immune system: The addition of an immunomodulatory medication like cyclosporine ophthalmic has demonstrated effectiveness in reducing inflammation in cases of posterior blepharitis. These drugs work by inhibiting the body’s natural immune response, leading to a decrease in inflammation.
• Treatments for underlying conditions: Blepharitis can be worsened by skin diseases such as rosacea, or eye problems such as dry eyes. Certain tablets, skin creams, or eye drops for dry eyes may be beneficial in these circumstances. It is critical to address the underlying causes of blepharitis to address symptoms.
• Clinical procedures: Other treatments, such as using powerful pulsed light, may be able to clear the glands. A heat treatment which warms the lids may help release harmful oils.