Bright Sight

Oliver Backhouse, Consultant Eye Surgeon www.cataract.org.uk

Blepharitis/Eyelid Cysts

1] What is Blepharitis?

This is a name given to inflammation of the edges of the eyelids. It is a common condition and can be present for many years before it is properly diagnosed. It can give various symptoms such as a gritty feeling, light sensitivity, tiredness, redness, dry eye, burning and a foreign body sensation. It usually affects both eyes and can contribute towards Styes (an infected gland at the base of the eyelash), eyelid cysts and dry eye discomfort.

2] Treatment of Blepharitis.

A combination of various treatment forms such as warm compressions, eyelid cleaning, artificial tears and antibiotics is usually enough to control symptoms. It is very important to realise that while Blepharitis will last for many years the symptoms can be kept under control by strictly following these treatment suggestions.

  • Firstly wash your hands before you follow the steps below.
  • Warm Compressions / Massage: This loosens up the crusting at the eyelash base and makes cleaning more effective. Use a clean hot flannel placed on closed eyelids for 5 minutes four times a day. Gently massage the lids while this is being done.
  • Eyelid Cleaning: Put a teaspoon of baby shampoo into an eggcup of warm water. Dip in a cotton wool bud and clean the base of the eyelashes as they come out of the eyelids. Be careful not to scratch the eye. This should be done to all 4 eyelid edges and performed twice a day for 2 weeks to start with before reducing to once a day or less. Alternatively use the ready prepared solution of Blephasol / Blephagel or the medicated wipes Blephaclean. These can be ordered on 0845 521 1290 or via www.blepha-store.co.uk
  • Artificial Tears:There are many different types but a good one to use would be Liquifilm (drops), Hyabak (preservative free drops) or Geltears (Gel) used four times a day. They can help lubricate the eye and dilute the slightly acidic tears due to the Blepharitis. They can be got at any Chemist.
  • Antibiotics: After having cleaned the eyelids, place a small amount of Fucithalmic antibiotic eye cream onto a clean fingertip and massage this into the base of the eyelashes. This should be done twice a day for 10 days. It can be repeated. This medication needs a prescription.

3] What if the Symptoms still continue?

It may be because you have Posterior Blepharitis which is more deep set and can respond to a 2-3 month course of Doxocycline (an oral antibiotic). Make sure your cleaning technique is good and the artificial tears are being used frequently enough. Should they be required more than four times a day, or you are sensitive to eye drop preservatives, then a preservative free formula would be advised such as Celluvisc. Occasionally a weak Steroid drop is used but this should only be done under the care of an Ophthalmologist.

Do not stop the treatment plan for your Blepharitis or the symptoms will recur. The frequency of the regime will vary between individuals and also from month to month. Try to avoid mascara when they eyes are bad.

Blepharitis is a controllable problem and advice from an Ophthalmologist can help as well as make sure there is no other condition such as Uveitis which can give some similar symptoms.

4] Eyelid Cysts

Inflammation of the eye lid margins can give rise to an infected eyelash root and this is called a Stye. Removing the offending eyelash and bathing the eyelid with the regime written above can help.

A Chalazion or Meibomian Cyst is a collection of the oily part of the tear film which comes from the glands in the edge of the eyelid. If the ducts which release this oil are blocked then the oil builds up into a cyst which can look and feel like a small pea in the eyelid. They can be single or multiple but over 90% will go on their own over several months. Should they get infected they will become large and sore and this is when antibiotics by the mouth are given. Should the cyst still remain after a 6 month period then a small eyelid operation to release the collection of oil can be done in clinic as an outpatient. This take place on the inside of the eyelid and so does not leave a scar. Following the Blepharitis treatment regime can reduce the frequency of these cysts and speed up their recovery.