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Blepharitis: symptoms and treatment, prognosis

Blepharitis is a serious eye disease with a chronic course. Starting with minor external changes, the first symptoms of blepharitis are often neglected.

And only pronounced signs of the disease (severe swelling, itching and sore eyes), which often indicate the already developed chronic form, cause the patient to consult a doctor.

And although blepharitis rarely affects visual acuity, in order to avoid unpleasant cosmetic defects and a long course of treatment, the disease should be treated immediately after the first signs appear (see photo).


Blepharitis - what is it?


Blepharitis symptoms close-up photo

Blepharitis symptoms close-up photo

Blepharitis is a chronic inflammatory process of various origins, developing along the edges of the eyelids. The disease gradually progresses, its symptoms are aggravated, and treatment with worsening of the condition becomes less effective.

Blepharitis, in most cases, non-communicable bilateral disease, resulting in cosmetic defects - loss of eyelashes and their growth inside, eversion of the eyelids. The disease is considered a companion of the elderly, however, it is sometimes diagnosed in children.

Localization of inflammation are distinguished:

  • anterior marginal - mild form, affecting the eyelids only along the ciliary margin;
  • posterior margin - deeper inflammation affecting the meibomian glands;
  • angular (angular) - inflammatory lesion with a typical localization in the corners of the eyes.

Blepharitis with a clear limitation of inflammation is extremely rare. Most often, patients refer to ophthalmologists with a common lesion of the eyelids.

The main causes of blepharitis:

  1. 90% of cases - reproduction in the thickness of the eyelids Staphylococcus aureus;
  2. The development of fungal, bacterial (blepharitis in children is often triggered by Staphylococcus epidermidis);
  3. Reproduction in the ciliary follicles of the skin mite Demodex (for this, the effect of a provoking factor is necessary);
  4. Allergic reaction to dust, smoke, cosmetics and other allergens;
  5. Long-term current conjunctivitis and severe dry eye syndrome;
  6. Farsightedness (without wearing glasses) and astigmatism.

The provoking factors include all conditions that are accompanied by a decrease in immunity - anemia and vitamin deficiencies, gastrointestinal diseases, caries, hormonal changes in adolescence, chronic inflammation of the nasopharynx, including tonsillitis and polyps in the nose.

Symptoms of blepharitis photo

The first symptoms of blepharitis photo

The following signs indicate the development of blepharitis:

  • Puffiness and redness of the upper / lower eyelid;
  • The burning sensation (mote sensation after the eyelid) and severe itching - blepharitis in children is often complicated by conjunctivitis due to constant rubbing of the eyes;
  • The appearance of scales on the eyelid for the growth of eyelashes;
  • The secretion of a thick serous / purulent secret, due to which the eyelashes stick together;
  • Increased lacrimation, photophobia;
  • Rapid eye fatigue even with a slight strain on vision;
  • Loss of eyelashes and a change in the direction of their growth (bundles, inside the eye orbit) - appears with long-term blepharitis.

signs of blepharitis photo

Signs of various clinical forms are added to the general symptoms of blepharitis.

Symptoms of blepharitis by type of flow:

Scaled blepharitis

The name speaks for itself. The main sign of scaly inflammation of the eyelid margin is the appearance of scales firmly attached between the eyelashes. Their separation does not cause damage to delicate skin and does not lead to bleeding.

The edges of the eyelids are covered with yellowish crusts. formed during the drying of the secretion of sebaceous glands. Another name for scaly inflammation is seborrheic blepharitis. This form often occurs on the background of seborrhea of ​​the scalp, eyebrows, behind the ears.

Initially, the dull external picture of the disease is gradually aggravated: the eyelids swell more and more and cannot fit snugly to the eyeball.

As a result, tearing appears, and inflammation captures the conjunctiva of the eye (blepharoconjunctivitis). A protracted disease is accompanied by focal loss of eyelashes, often inversion of the century.

Symptoms of blepharitis photo

Symptoms of blepharitis photo

Staphylococcal (ulcerative) blepharitis

The most severe form of inflammation of the eyelids. In the ciliary sacs pus is formed. Inflammation occurs with the formation of purulent crusts. Their separation is quite painful, the opened sores bleed, covered with purulent bloom.

The affected eyelashes fall out, and the ulcerative lesions gradually tighten with the formation of scars. All this leads to a gradual deformation of the eyelids and the complete absence of eyelashes.

Allergic blepharitis

May occur when eye contact with a sensitizing agent (fluff, dust, etc.), with sufficiently long use of drops and ointments for the eyes.

Especially vivid symptoms observed in the acute period: pronounced swelling of the eyelids, tearing, severe itching, feeling cramps in the eyes and photophobia.

Much secretion is liberated from the eyes. In remission, unbearable itching comes to the fore, and scratching often provokes the addition of an infection.

Demodectic blepharitis

A typical picture of the lesion of the edge of the eyelids with a tick: thickening of the eyelids in combination with hyperemia and itching, worse after waking up and in a warm room. The sticky secretion secreted by the sebaceous glands, when drying, forms a “collar” (edging) around the ciliary base.

Meibomium blepharitis

People call the disease barley . However, barley is just acute inflammation of one gland, and meibomian blepharitis encompasses several, located in the thickness of the eyelids of the sebaceous glands.

In this case, inflammation is triggered by hypersecretion of the meibomian glands and difficulty in secretion of the secret. The eyelid is covered with gray-yellow crusts, a yellowish secret is released when pressed.

A characteristic feature of meibomian blepharitis is foamy purulent mucus in the corners of the eyes. Often this form of inflammation is combined with conjunctivitis.

Corner blepharitis

Often diagnosed in adolescents - the corners of the eyelids thicken, the eye-catching secret eats away the tender skin of the eyelids, forming cracks and micro-ulcers.

Acne blepharitis (rosacea)

Often proceeds against the background of rosacea of ​​the skin (rosacea). Doctors take an important role in its formation to the Demodex mite and enhanced blood flow. The skin of the eyelids is covered with dirty red nodules, in the center of which a watery vesicle (pustule) is formed.

Treatment of blepharitis

Treatment of blepharitis

An eye examination is usually sufficient for a diagnosis. A microscopic examination is performed to detect demodex inflammation - a tick is found at the roots of the removed eyelashes.

In severe cases and in the absence of a minimal therapeutic effect, the doctor prescribes a laboratory study of secretions secreted.

When treating blepharitis, be patient: a course of therapy is 1–2 months. To achieve the result, it is necessary not only to apply medicinal products (determined depending on the form of the disease), but also to raise to the rank of habit careful eye hygiene.

Hygiene measures

A patient with blepharitis should regularly perform:

  1. Abandon cosmetics - any cosmetic will only aggravate the course of the disease.
  2. Cleansing the eyelids from the crusts and removing mucus - for easier cleansing, it is recommended that the eyelids be wetted with a cotton ball dipped in warm water. Light movements are made from the outer to the inner corner of the eyes.
  3. regular treatment with antiseptics - Furacilin, brilliant green (quickly absorbed into the pores, leaving no traces).
  4. Warm compresses - three times a day, a napkin / cotton ball with warm (not hot!) Water is applied to the sore eyes. The warming procedure, especially in combination with a light massage of the eyelids, promotes relaxation of the excretory ducts of the glands of the eyelid and speedy release of the secret. The duration of the procedure is up to 10 minutes. Compresses are contraindicated in demodex inflammation (increase itching)!

Drug therapy

Preparations for the treatment of blepharitis century designed to eliminate the cause of the disease and alleviate the symptoms. To do this, apply:

  • Moisturizing drops Artificial tear and Otholik with dry eyes.
  • Antibacterial drugs for the eyes - Erythromycin, Tetracycline and Trobramine ointments, liniment Chloramphenicol, Gentamicin drops are most effective. In severe cases, it is advisable to systemic use of antibiotics.
  • Hormonal ointments - products containing Hydrocortisone or Dexamethasone, are prescribed only with the ineffectiveness of antibacterial agents. Often used the combination drugs Dex-Gentamicin (Dexamethasone and Gentamicin) or Maxitrol (Dexamethasone, Neomycin, Polymyxin). The course of treatment with corticosteroids should not exceed 10 days.
  • Ulcer healing - Solcoseryl gel, drops Korneregel.
  • To inactivate demodex - gently smearing the edges of the eyelids with alcohol (avoid contact with the eyes!), Abundant lubrication of the eyelids with Hydrocortisone ointment, treatment of the eyelids with anti-parasitic agent Ivermectin or Benzyl Benzoate. Also against the tick eye gel with metronidazole is effective. This drug in tablet form is used for a protracted course of blepharitis course of 10 days.
  • When allergic blepharitis - tablets Loratadin, Suprastin and other antihistamines with the obligatory identification and elimination of the allergen.
    Enhance immunity - vitamin therapy.

Diet for blepharitis treatment

When treating blepharitis, a diet is recommended, since the patient must receive with nutrition enough vitamins (especially A, D, B), proteins and unsaturated fatty acids. It is recommended to include in the menu:

  • fish and seafood;
  • meat and liver;
  • dairy products and eggs;
  • cereals, legumes;
  • nuts, dried fruits, mushrooms;
  • vegetables - potatoes, carrots, cabbage, beets, bell pepper;
  • fruit - melon / watermelon, pomegranate, apricot / peach, citrus;
  • onions, garlic and greens - lettuce, dill, spinach, horseradish;
  • any compotes and natural juices.

Exceptions to be fried dishes, pickles and marinades, sweets.


Blepharitis - recurrent pathology. The effectiveness of treatment depends on the regularity of eyelid hygiene and proper drug therapy. However, even this does not exclude periodic exacerbations.

Regarding the preservation of visual acuity with blepharitis, the prognosis is favorable. It is also worth considering the risk of cicatricial deformity of the eyelids requiring surgical correction, and the likelihood of cancerous degeneration of severe forms of blepharitis with severe ulceration and hypertrophy of the eyelids.


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