How to care for eyelids and treat blepharitis: effective hygiene tips

30/12/2024

Blepharitis is an inflammation of the eyelids, particularly along the eyelid margins, that can affect people of all ages, including adults and children. This condition may cause uncomfortable symptoms such as redness, itching, burning, tearing, light sensitivity, and a foreign body sensation in the eyes. While often chronic and not always curable, proper eyelid hygiene is essential to alleviate symptoms and prevent complications.

Types of blepharitis

Blepharitis is classified into two main types:

• Anterior blepharitis: Affects the base of the eyelashes and can be further divided into:
  • Seborrheic: Characterized by the buildup of dandruff-like oily material.
  • Infectious: Typically caused by Staphylococcus bacteria or, in some cases, fungi.
  • Parasitic: Associated with the presence of the Demodex mite.
     

Lack of hygiene is often a contributing factor in infectious anterior blepharitis.

• Posterior blepharitis: Involves the Meibomian glands, which produce essential lipids for tear film stability. Dysfunction in these glands, such as blockage or atrophy, can lead to evaporative dry eye.

Long-term complications

Without proper management, blepharitis can lead to issues such as styes, chalazia (sebaceous cysts on the eyelids), and chronic surface eye conditions like conjunctivitis or corneal lesions, which may compromise visual quality. Additionally, it is often associated with dry eye syndrome, as inflammation affects tear production and quality, exacerbating ocular discomfort.

The importance of eyelid hygiene

Maintaining proper eyelid hygiene is crucial for controlling blepharitis. Regular cleaning removes bacteria, oil buildup, and cellular debris that contribute to inflammation. It also enhances the function of the Meibomian glands, reduces secretion buildup, and stabilizes the tear film. A consistent daily hygiene routine can alleviate symptoms and prevent recurrence.

How to perform effective eyelid hygiene

Follow these steps for proper cleaning:

1. Apply heat:
   Use dry heat on the eyelids for 5–10 minutes (specific eye masks are available for this purpose). Heat facilitates the drainage of the Meibomian glands and opens their ducts.
2. Eyelid massage:
   After applying heat, gently massage the eyelid margins to release trapped secretions and clear the glands.
3. Cleanse:
   • Use specific eyelid products like antiseptic wipes or cleansing foams to keep the eyelid margins clean.
   • Alternatively, mix warm water with a few drops of baby shampoo (neutral pH).

Additional treatments and care

• For anterior blepharitis:
  Eyelid cleaning is essential. In cases of bacterial infections, ophthalmologists may prescribe topical antibiotics. For Demodex infestations, products containing tea tree oil (designed for eyelid use) are commonly recommended. Persistent cases may require professional micro-exfoliation of the eyelid margins.
• For posterior blepharitis:
  Basic treatment involves regular use of dry heat and eyelid massages. If these measures prove insufficient, advanced therapies like regulated intense pulsed light (IPL) may be used to unclog the Meibomian glands.

For both types of blepharitis, artificial tears can help maintain ocular lubrication until tear film quality is restored.

By following a consistent hygiene routine and adhering to treatments prescribed by a specialist, it is possible to control blepharitis symptoms and significantly improve quality of life.

Dr. Ainhoa Martínez Grau, Ophthalmologist at Barraquer Ophthalmology Centre