Blepharitis treatment options for dry eyes / eye irritation - A State of Sight #117

Blepharitis is a common cause of dry eyes that results in inflammation and irritation of the oil glands that lubricate the eyes. Fortunately, several treatments are available to make the eyes more comfortable.

Watch this episode of A State of Sight with Isaac Porter, MD to learn more about potential treatments for blepharitis. These include scrubbing the eyelids, antibiotic ointments or pills, and potentially steroids.

Welcome to A State of Sight, I’m Isaac Porter and this is your update in ophthalmology and eye care from Raleigh. Today, I would like to explain some of the treatments for blepharitis, which is a form of dry eye syndrome.

If you look back at episode #82 of A State of Sight, I go into more detail of blepharitis (which is also called meibomian gland dysfunction). Basically, it is inflammation and irritation of the oil glands along the inside edge of the eyelids, right behind the eyelashes. In addition to inflammation, there can also be bacterial overgrowth or bacterial infection that contributes to the eyes becoming uncomfortable. At times the eyes can become red, sticky, and irritated from blepharitis.

One of the primary blepharitis treatments is scrubbing and massaging the eyelids to help the oils flow better. Patients can do this with a mild soap or a baby shampoo right along the eyelashes to help move the oils and open the oil glands. This is best done after a warm compress that is as hot as it can be without burning the eyelids. I recommend the warm compress for at least 4 minutes then once the oils are warmed and thinner, they have a better chance to move.

Based upon some of these ideas, an in-office treatment has been developed called LipiFlow. This uses a unit that is placed on the eyelids which warms and massages the eyelids to really get the oils moving. The effects may last from six to twelve months or maybe longer. Patients have been shown to be more comfortable afterwards when some of the blocked oils have been moved and the glands are flowing better.

Antibiotics are another treatment option. Often, it is not just the antibiotic effect that helps to improve meibomian gland dysfunction, since some antibiotics can also work as antiinflammatories. Antibiotic ointments like erythromycin or bacitracin can be placed along the eyelids and in the eye at bedtime. Azithromycin drops can be used in the same manner. Alternatively, doxycycline or other antibiotics in the tetracycline family can be taken by mouth. These pills are particularly helpful with patients who have rosacea contributing to the blepharitis.

In limited situations, steroids may be helpful for blepharitis, particularly if there is overgrowth of bacteria (usually staph). These bacteria can cause inflammation of the cornea or conjunctiva that may require steroids for improvement. There are potential side effects from steroids including increased eye pressure, glaucoma, or cataracts, but in controlled and monitored cases, they are generally safe.

If you have blepharitis or you wonder about any other treatments or ways to become more comfortable, please post and we will be happy to answer them. Give our office a call at (919) 876-4064 to schedule your evaluation for blepharitis. Hopefully see you again soon on our next episode of A State of Sight.