The most common reason for people to have long-term itchy or slightly uncomfortable eyes is inflammation in the skin around the bases of the eyelashes i.e. at the lid margins, and is called Blepharitis.
Blepharitis is not usually due to tissue infection, but rather is due to inflammation only. However, organisms (usually bacteria or yeasts) on the skin surface do play a part in causing the inflammation.
It can develop at any age, and symptoms can include:
- itchy, sore and red eyelids that stick together
- crusty or greasy eyelashes
- a burning, gritty sensation in your eyes
- increased sensitivity to light (photophobia)
- swollen eyelid margins
- finding contact lenses uncomfortable to wear
- abnormal eyelash growth or loss of eyelashes in severe cases
In most cases both eyes are affected, but one eye can be more affected than the other. The symptoms tend to be worse in the morning.
Blepharitis is usually a long-term condition. Most people experience repeated episodes, separated by periods with reduced symptoms.
Blepharitis isn't contagious.
What causes blepharitis?
Blepharitis is usually an interaction between oils produced by the eyelid glands and the bacteria/yeasts that live on the glands. Occasionally an aggressive bacterium (Staphylococcus Aureus) is a significant part of the cause, and in these cases a few days of treatment with antibiotic (ointment rubbed into the lashes twice per day) is very helpful.
Blepharitis can be divided into three types: Anterior, posterior, and mixed (anterior and posterior). The subdivision into these three types is not clinically very useful because
i) the mixed type is by far the most common, and
ii) the treatments outlined above are used effectively for all three types.
Sometimes blockages in the Meibomian glands are associated with a skin condition called rosacea. If too much oily substance is being produced, this may be caused by seborrhoeic dermatitis which commonly affects other areas of the body (e.g. the face and/or scalp) and many people with itchy eyelids due to blepharitis also have itchy, flaky ("dandruff") scalp.
When to get medical advice
See your high-street optician (optometrist) or an eye specialist if you have persistent symptoms of blepharitis that aren't being controlled by simple eyelid hygiene measures.
If you have severe symptoms (for example severe redness or lid swelling), contact your optometrist or GP immediately. If this isn't possible, visit your nearest accident and emergency (A&E) department.
How blepharitis is treated
A tendency to blepharitis can't be cured, but the condition can be completely controlled - it's exactly the same idea as washing your hair regularly to prevent itching and inflammation of your scalp, and a daily eyelid-cleaning routine can help control the symptoms and prevent permanent scarring of the eyelid margins.
There are three main steps to eyelid hygiene that should be performed, morning and evening to start with, and then most people find that about three times per week is enough to keep control of it:
- using a warm compress – to make the oil produced by the glands around your eyes more liquid so it can flow out of the glands instead of blocking them. Heat pads that can be warmed in the microwave and rested on your closed eyelids have been proven to be very effective in reducing/removing symptoms and preventing long-term complications of blepharitis.
- gently massaging your eyelids – to push the oils out of the glands
- cleaning your eyelids – to wipe away any excess oil and remove any crusts, bacteria, dust or grime that might have built up
More severe cases may require antibiotics that are either applied to the eye or eyelid directly, or taken as tablets.
Complications
Blepharitis isn't usually serious, although it can lead to a number of further problems.
In the next post (above) we'll begin to look at the more serious problems that can occur if blepharitis remains untreated for years, and therefore why the relatively simple treatments outlined above should be commenced whilst the condition is mild - if you have irritating eyes, don't put up with it - get it sorted.
How is the name "Blepharitis" derived ?
Inflammation is the response of the body to noxious stimulus (chemical/injury/infection).
The Greek word for eyelid is "blephar" and the suffix "-itis" (again from Greek) is appended (as it is to the name of any body structure) to indicate inflammation.
The Greek word for eyelid is "blephar" and the suffix "-itis" (again from Greek) is appended (as it is to the name of any body structure) to indicate inflammation.
Authoritative government source:
http://www.nhs.uk/conditions/Blepharitis/Pages/Introduction.aspx
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