Understanding Blepharitis: Symptoms and Treatments for Swollen Eyelid

Blepharitis is a prevalent condition characterized by inflammation of the eyelids, often leading to discomfort and a noticeably swollen eyelid and red eye. Understanding the symptoms and treatments for blepharitis is essential for managing this chronic, yet non-contagious, eye condition. In this comprehensive guide, we will explore the various symptoms of blepharitis, its causes, and the most effective treatments available.

What Are Some Common Symptoms of Blepharitis To Look Out For?

Recognizing the symptoms of blepharitis is the first step towards effective management and treatment. The condition typically affects both eyes and can present a range of symptoms that vary in severity.

1. Swollen Eyelids: One of the most prominent symptoms of blepharitis is a swollen eyelid or eyelids. This swelling is often accompanied by redness and a sense of heaviness in the eyelids.

2. Irritated, Red Eyes: Individuals with blepharitis frequently experience redness in the eyes. Red eyes can cause the eyes to feel itchy or burn, leading to significant discomfort.

3. Crusting of Eyelashes: Crusting or flaking around the eyelashes is another common symptom. This crusting is usually more noticeable in the morning and can cause the eyelids to stick together.

4. Greasy Eyelids: The eyelids may appear greasy due to the excessive production of oils by the meibomian glands. This can also lead to dandruff-like flakes on the eyelashes.

5. Dry Eye or Excessive Tearing: Blepharitis can disrupt the normal production of tears, resulting in dry eyes or, paradoxically, excessive tearing. Both conditions can further irritate the eyes.

6. Photophobia (Light Sensitivity): Increased sensitivity to light, or photophobia, is another symptom associated with blepharitis. This can make it difficult to be in bright environments.

7. Blurred Vision: Blurred vision may occur, particularly in severe cases. This is usually temporary and related to the inflammation and debris affecting the tear film.

8. Loss of Eyelashes: Chronic blepharitis can lead to the loss of eyelashes or abnormal eyelash growth, where lashes grow in the wrong direction (trichiasis).

What Are the Most Common Causes of Blepharitis?

Understanding the underlying causes of blepharitis is crucial for effective treatment. Several factors can contribute to the development of this condition.

1. Meibomian Gland Dysfunction (MGD): MGD is a common cause of posterior blepharitis. When the oil glands in the eyelids produce thick or unhealthy oils, it can lead to inflammation and eye infection.

2. Skin Conditions: Skin conditions like acne rosacea and seborrheic dermatitis (dandruff) can trigger blepharitis. Rosacea causes facial skin inflammation, including the eyelids, while dandruff can lead to flakes that irritate the eyelids.  Severe allergic contact dermatitis to poison ivy can be problematic as well..

3. Allergies: Allergic reaction to contact lens solutions, eye drops, or eye makeup can cause blepharitis. These irritants can lead to chronic inflammation if not addressed.

4. Infections: Bacterial infections, particularly those caused by Staphylococcus bacteria, can result in staphylococcal blepharitis. This type is characterized by missing eyelashes or lashes that grow abnormally.

5. Dry Eyes: Inadequate tear production or poor-quality tears can contribute to blepharitis. Dry eyes can alter the eye's natural bacterial resistance, leading to infections.

6. Lice or Mites: Infestations of lice or mites (Demodex) in the eyelashes can block follicles and glands, causing inflammation and irritation.

What are the Most Common Treatments for Blepharitis?

Managing blepharitis involves a combination of self-care practices and medical treatments. Here are some effective strategies to treat a swollen eyelid caused by blepharitis.

1. Maintaining Eyelid Hygiene: Keeping the eyelids clean is crucial in managing blepharitis. Regularly cleaning the eyelids with warm compresses and lid scrubs can help reduce symptoms.

• Warm Compresses: Applying a warm compress to the eyelids helps to loosen crusts and oily debris. Use a clean washcloth soaked in warm water, wring out the excess water, and place it over the eyelids for several minutes. Repeat as necessary to maintain warmth.

• Lid Scrubs: Over-the-counter lid scrubs are available as sprays, foams, or towelettes. Alternatively, you can make a solution of 50% baby shampoo and 50% water. Using a clean cloth, gently scrub the eyelid margins to remove crusts and reduce bacteria.

2. Avoiding Eye Irritants: Temporarily avoiding eye makeup and other potential irritants can help reduce inflammation. Ensure to thoroughly remove any eye makeup before bedtime. If you have glasses, avoid wearing contact lenses.  

3. Dietary Adjustments: Including omega-3 fatty acids in your diet, either through supplements or foods like fish and flaxseed oil, can improve the function of the meibomian glands. Additionally, consuming green leafy vegetables and avoiding high-fat foods can be beneficial.

4. Antibiotics: For bacterial infections, your eye care provider may prescribe antibiotic ointments or eye drops. Common options include erythromycin, bacitracin ophthalmic, or Polysporin® ointments. In persistent cases, oral antibiotics like doxycycline or azithromycin may be necessary.

5. Anti-inflammatory Medications: If inflammation is severe, steroid eye drops or creams may be prescribed to reduce swelling and irritation. These are often used in conjunction with antibiotics for comprehensive treatment.

6. Immunomodulatory Drugs: For cases of posterior blepharitis, immunomodulatory drugs like cyclosporine ophthalmic (Restasis®) can be effective. These medications reduce the immune response and inflammation in the eyes.

7. Clinical Procedures: Certain in-office procedures can provide relief for chronic blepharitis

• Lipiflow®: This procedure involves applying heat and gentle pressure to the eyelids to express unhealthy oils from the meibomian glands.

• Intense Pulsed Light Therapy: Bright red light pulses are applied to the eyelid skin to reduce inflammation and improve gland function.

• BlephEx®: This procedure involves using a medical device to clean the eyelid margins and remove debris.

8. Preventative Measures:

• Practice good facial and eyelid hygiene daily.

• Avoid touching your eyes with unclean hands.

• Remove all eye makeup before sleeping.

• Use artificial tears to manage dry eyes, if recommended by your provider.

• Use anti-dandruff shampoo to reduce scalp flakiness.

• Replace eye makeup regularly to avoid bacterial contamination.

Call NCEENT To Start Down a Path to Relief!

Blepharitis, a common cause of swollen eyelids, can be effectively managed with proper hygiene and while some home remedies can help to ease symptoms, medical treatments from your eye doctor may be necessary to ensure the condition does not progress and/or is not a sign of a more serious condition.

By understanding the symptoms and underlying causes, individuals can take proactive steps to reduce flare-ups and maintain eye health. If you experience persistent symptoms, consult with the medical professionals at NC Eye, Ear, Nose, and Throat to develop a personalized treatment plan with your eye doctor.