Blepharitis. *there won’t be many pictures for this blog as I didn’t want to gross anyone out – only one* One of the most common and under-diagnosed conditions I find seeing patients of all ages. Blepharitis is the “inflammation of the eyelid”. It doesn’t necessarily mean that the eyelids themselves are inflamed – only worse case scenario does this actually happen. More commonly, what I see is debris build up along the base of the eyelashes (where the eyelashes grow from). The debris is usually a result of environmental factors and eyelid hygiene. If a person works in a dusty environment without proper protective eye wear and doesn’t spend the time to clear the debris from their lashes, there will be a lot of clumped up dirt stuck in between the lashes and along the base. Our eyes naturally produce oils that are involved in the stabilization of the tear film, so it’s natural to have oils here. But issues arise when these glands get clogged by the build of up debris or lack of activation (meibomitis).
A lot of people may have blepharitis and be asymptomatic for the most part if the debris isn’t bothering their eyes. Where as the symptomatic person will find their eyes to be irritated, red, or itchy at times. Worse case scenario, there’s so much gunk that your lashes get stuck, the glands are all clogged, eyelids get inflamed, glands inflamed, and everything is just a mess. Blepharitis and meibomitis are often triggers for dry eye and in order to treat the dryness, the lid hygiene has to be addressed first.
My best advice for people with blepharitis (whether they are symptomatic or not) is to start paying attention to lid hygiene. The simplest way is to get some baby shampoo (there are specific products but unless it’s that severe, baby shampoo should be fine) and incorporate the following into your daily night/morning routine (which ever works best for you or both if it’s severe): take a small dime-sized amount (per eye) and rub it along the base of your lashes gently with your eyes closed for a good 5-10 seconds, then rinse it off with warm water. This well help to clear up the debris. If the glands are also clogged (meibomitis), it will require a little more work. Lid hygiene is always important, but you will have to include warm compresses. The best option is to invest in a proper eye mask that can be heated and hold the heat. Use this on your eyes with moderate heat for a good 5-10 minutes after washing the area to open up the glands. Afterwards, use a clean warm face cloth and gently massage around the base of the eye lashes (top and bottom) with your eyes closed for another good 3-5 minutes. This will help to open up the clogged glands and get rid of whatever is stuck in them. It is important to stick with the routine to ensure it doesn’t happen again.
Another thing to consider for individuals that stare at a screen for majority of the day is how much you’re blinking. Studies have shown that computer users blink 50% less than they should be when they’re looking at a screen. The importance of blinking is quite underrated. What blinking does is it spreads our tear film out evenly and refreshes the tear film so that the cornea has an even coating of tears. When our tear film is uneven, this is when people often feel their eyes are dry. Proper blinking is also something to consider. The meibomian glands (glands that produce the oils for tear film stability) are activated by the pressure created during a full blink where the top and bottom eyelids touch. If there isn’t enough pressure or the lids don’t touch, the oil is not secreted (but is still being produced which causes a blockage). This creates a lack of the stability layer of the tear film and causes the tears to dry up faster than they should – thus causing dryness in the end. To ensure we’re blinking properly, follow these steps: place your fingers beside your eyes where the top and bottom lid meet, then close your eyes enough to feel your fingers move from their initial placement. Once you feel that movement, that is the amount of pressure needed to activate the glands. Once you get the feeling of this, you don’t need to put your fingers up every time – it’s just so you can feel it the first couple of times. This ensures that your blink is complete. Remember to do about 10 of these good quality blinks every 10 minutes or so when spending a lot of time on a computer. This will ensure your tear film is being spread evenly and is of good quality. Don’t forget about eyelid hygiene! Proper blinking is useless without first unclogging the glands.
For women, it is super important that we completely remove our eye make-up before we go to bed. Make-up can easily clog the glands – especially when you tight-line your eyes. The glands are located along the eye lid where women tend to “tight-line” their lids. There are many women that I’ve seen where they have make-up and glitter swimming in their tear film that irritates their eyes. Wearing less make-up is not usually an option, so my recommendation would be to be more careful with their application and try to avoid tight-lining if possible. Fake lashes are also a contributing factor. Ensuring that all the glue is removed is important and to not sleep with them on. I myself have eyelash extensions. I haven’t had any issues with the glues that the lash technicians I’ve gone to have used on me but I always ensure that I keep my lashes clean and remove any debris that I see along my lash line. Make-up removal is tricky with extensions but definitely take the time to make sure it’s all removed properly.
We will soon be offering a new eye lid treatment at Wink Optometry that involves everything I’ve talked about and a little bit more. If you’re experiencing dry eyes or just want to check it out it’s worth a try. It’ll include eyelid cleansing, warm eye-mask, tea-tree oil treatment, and meibomian gland expulsion. Ladies please come without make-up. The first month will be complimentary with full eye exams! Stay tuned to find out when!