How to control your blepharitis (3)

In the previous posts (below) we've talked about Blepharitis being very common, indeed that most people have at least some blepharitis; and how, although it is initially relatively symptom-free, if untreated for years it can cause really serious eye disease and eventually loss of vision. We're all living much longer these days, so we need to think ahead and keep ourselves as healthy as possible so we don't spend our latter years with vision problems that could have been prevented by simple health care.

People who have a tendency to develop blepharitis will have that tendency for many years or all of their life. Cure is not possible, but complete control is absolutely possible and is important. 

Regular treatment is necessary - the inflammation tends to recur if you don't maintain this. 

Regular eyelid hygiene

This is a simple routine that consists of three parts - warmth, massage and cleaning.

1. Warmth

The purpose of warmth is to melt the oily secretions made by the eyelid's oil glands, to allow the oil to flow more freely and thereby unplug any glands blocked by that oil. Warmth applied to the eyelids for five to ten minutes is sufficient to do this.

The traditional method is to press on the eyelids gently with a flannel (facecloth) soaked in very warm water for 5-10 minutes. If the flannel cools, keep re-warming it in the warm water.

A popular alternative is to use a proprietary reusable heat pad which you place over your eyes for about five minutes. The heat pad can be more convenient than wet flannels, for example at work; they also retain their heat for longer so you can simply lie down and relax for five to ten minutes with the bag placed over your eyes. According to our patients, one of these pad types is particularly good - very convenient (you can use them wherever you are even if you don't have access to a microwave or electrical power) and the most hygienic available - click HERE to buy these quite cheaply through Amazon, or telephone (UK) 01727 812925 to buy them even more cheaply if you are local to, and can collect from, the St Albans Eye and Vision Clinic. Since these have been available, over the last few years, they have really improved the treatment results achieved by our patients.

2. Massage

Immediately after applying the warmth, massage very gently downwards on the upper eyelid, and upwards on the lower eyelid, to encourage the oily secretions toward the lid margins and out of the glands.

3. Clean

After warmth and massage, clean the eyelid margins to remove the oil and any scales or crusts. This can be done by either of the following ways, and different methods suit different people:

• Diluted baby shampoo (ten drops in a small cup of warm water) or sodium bicarbonate (a teaspoonful in a cup of warm water); use either of these on a cotton bud to clean off any crusts at the base of the eyelashes, followed by rinsing the eyelids in clean water. A flannel can be used instead of the cotton bud.
• Proprietary eyelid scrubs that you can buy; our patients have tried several of these, and one of the best can be purchased cheaply HERE. We'll keep searching for the lowest prices for these products, so you'll always get best value here.

If you've used a dry heat bag for the warmth stage, your eyelids won't have had the soaking effect of hot water, so you need to spend longer soaking crusts and scales and removing them from the lid margins, especially from between the eyelash bases. If you've used a moist heat bag, or hot wet flannels, then the crusts and scales should be already soft and ready to remove. The blepharitis is generated underneath these crust and scales, so whatever method you use, it's important to get all the crusts and scales off.

You should do the above routine - warmth, massage, clean - at least twice per day until symptoms settle. When the symptoms have eased, keep doing this routine at least three times per week to maintain control of your tendency to blepharitis. If you are prone to blepharitis it is best to think of this as part of your daily routine - just like brushing your teeth. Blepharitis tends to fluctuate and there will be times when it is a bit worse despite the treatment; overall, however, regular treatment will minimise symptoms and long-term complications.

Artificial tear drops

Blepharitis is often associated with dry eyes, so artificial tears/lubricants may help ease symptoms. Different preparations suit different people, so simply try one after the other until you find the one that suits you best.

Antibiotic and/or Steroid treatments

Antibiotic or steroid eye ointment or tablets are usually unnecessary, but may be prescribed for blepharitis unresponsive to the above treatment, or for cases where at the outset the examination suggests that bacteria are a large part of the cause.