Blefaritis

Blepharitis is a very common condition consisting of inflammation of the eyelid rim, where the eyelashes are born. There are different types of blepharitis, but in general they all manifest similar symptoms. Patients with blepharitis often complain of stinging, itching, red eyes, frequent sties and chalazions, and morning groping.

All these symptoms are due to bacterial overgrowth and/or dysfunction in the Meibomian glands of the eyelids, which are essential in the formation of the tear film. Blepharitis is considered a chronic condition, so there is no quick and easy cure. However, proper treatment can effectively control it. and provide great relief from the patient’s symptoms If there is an underlying cause, such as acne rosacea, treatment will be directed at the causal process.

Blepharitis Treatment

Typical scaling with blepharitis
Typical flaking around the eyelashes in a patient with blepharitis

There are different lines of treatment for blepharitis: The hygiene of the eyelids, antibiotic and anti-inflammatory ointments and oral treatments. Daily palpebral hygiene has proven to be the best treatment for the vast majority of patients with blepharitis. Ideally it should be done twice a day (morning and evening), especially at the root of the eyelashes. There are numerous commercial preparations consisting of wipes designed specifically for the treatment of blepharitis.

These wipes are prepared with a mild soap specially designed for this problem. An alternative to these products is to use baby soap cut in half with water and on a soft cloth. Daily palpebral hygiene, carried out on a daily basis, can provide effective and lasting control of your symptoms in the medium term. Palpebral hygiene is also performed today in the ophthalmologist’s office. Through the use of devices such as BlephEx, the edge of the eyelids can be cleaned very effectively, uncovering the Meibomio glands that have been blocked and with immediate symptomatic improvement on the part of the patient. Antibiotic ointments (with or without cortisone) are sometimes indicated for short periods of time if bacterial overgrowth is considered to exist. Treatment with oral doxycycline (antibiotic) can be very effective in certain types of blepharitis. Not because of its antibiotic properties but because of its modulating properties of the Meibomio glands. Nutritional supplements with antioxidants, vitamins and Omega 3 and 6 essential fatty acids have an increasingly proven role in the treatment of blepharitis, as they can improve the functioning of the Meibomian glands.

Chalacion

Large chalazion on left upper eyelid
Large chalazion on left upper eyelid

A chalazion is a nodule that forms on the eyelids due to an obstruction of the ducts of the sebaceous glands (meibomian glands) found at the palpebral margin. When the duct of one of these glands becomes blocked, fatty secretion builds up and the body reacts with an inflammatory process surrounding the gland. The main symptom of chalacion is the presence of a nodule on the eyelid. It may be painful initially and cause widespread swelling of the entire eyelid. The most common age of presentation is adolescence, due to the hormonal changes characteristic of this stage. Pregnancy can also lead to chalacions. Other risk factors are:

  • blepharitis (chronic inflammation of the eyelids)
  • Seborrheic dermatitis.
  • Acné

Chalazion Treatment

Approximately 25% of chalazion cases disappear without treatment. However, many times the chalazion becomes chronic and requires some type of treatment.

  • Treatment in the acute phase: Local heat ( e.g. hot cloths) applied several times a day can help unblock the glandular duct. In this phase it is also recommended to apply ointments with antibiotic and corticoid 1 or 2 times a day to decrease the inflammation.
  • Treatment in the chronic phase: When a chalazion does not resolve with the above measures, local injection of steroid is recommended. This can easily be done in the office without the need for anesthesia. The corticoid injected directly into the chalazion is very effective and resolves the vast majority of these. When a chalazion is resistant to this last treatment, the surgical treatment. With local anesthesia
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