Information on Eye Treatments - Blepharitis

 

What is the treatment for blepharitis?

There is no one-off cure for blepharitis, as the inflammation tends to recur if you do not keep up with treatment. However, with regular treatment, symptoms can usually be eased and then kept to a minimum. This helps to prevent flare-ups. The aim of treatment is to control or manage blepharitis, not to cure it. Most of the treatment is done by you, rather than having prescriptions or treatments from your doctor. The main treatment is regular eyelid hygiene (see below).

Regular eyelid hygiene

This is the most important part of treatment and prevention of blepharitis. The aim is to soothe the eyelids, unplug any blocked meibomian glands and clear out any stagnant oily secretions from these glands. The eyelids are cleaned and debris is removed. This is a daily routine that consists of three parts - warmth, massage and cleansing. Remove any contact lenses before following the routine.

Warmth

The purpose of warmth is to soften the skin and any crusts attached to the eyelids. It also allows the oily secretions made by the meibomian glands to flow more freely, as warmth makes oils more runny. Therefore, warmth helps to unplug any blocked glands and allow the oily secretions to flow more readily. 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 specially designed reusable heat bag which you place over your eyes for about five minutes. There are a number of such eye bags available, which you can buy from some opticians or online. The heat bags are warmed in a microwave. The advantage of a heat bag over a hot flannel is that the heat is retained for many minutes and so it keeps a constant warmth over the eyes. You can simply lie down and relax for five to ten minutes with the bag placed over your eyes. (A hot flannel usually cools quickly.)

Massage

Massage the eyelids immediately after applying the warmth. Massaging helps to push out the oily fluid from the tiny meibomian glands.

To massage the eyelids:

  • Massage along the length of the upper and lower eyelids towards the eye. That is, sweeping downwards when moving along the upper eyelid, and upwards when moving along the lower eyelid. The idea is that you are moving the oily secretions toward the edge of the eyelid so that they can come out of the glands.
  • Repeat this massage action 5 to 10 times over about 30 seconds immediately following the warming.
  • Massaging should neither to be too gentle nor too firm. It should be relatively comfortable and you should not press hard enough to actually hurt your eyeball under the closed lids. Always massage with the eyes shut.

Clean

After warmth and massage, clean the eyelids. This can be done by any of the following ways. There is a lack of research studies to say which is the best method, so use whatever you find most useful:

  • The traditional way is to use a cotton wool bud that has been dipped in diluted baby shampoo. Just add a few drops of baby shampoo to a small cup of warm water so that the ratio of water to shampoo is about 10:1. Squeeze out excess liquid from the cotton bud to prevent drips getting into your eyes, which may irritate. In particular, try to clean off any crusts at the base of the eyelids.
  • After cleaning the eyelids with the cotton wool bud, wash off the shampoo from the eyelids, using a flannel or cloth. Some people recommend using sodium bicarbonate (a teaspoonful in a cup of cooled water that has recently been boiled). This is applied using a clean cloth or cotton wool bud. This may cause irritation to the eyes in some people.
  • Some people recommend using special eyelid scrubs that you can buy at some opticians/optometrists. Some people say that simply washing the eyelids with cooled water that has recently been boiled (or preserved water for contact lens wearers) is probably as effective as using water with added sodium bicarbonate or baby shampoo.

 

You should do the above routine - warmth, massage, clean - at least twice a day until symptoms settle. When the symptoms have eased, keep doing this routine once a day, every day, to prevent further flare-ups. If you are prone to blepharitis it is best to think of this as part of your daily routine - just like brushing your teeth. This is the best way to keep symptoms away, or to a minimum.