Lid Margin Disease
Lid margin disease or blepharitis is a common and frequently chronic, ongoing inflammation of the eyelids. The hallmark symptoms are burning, especially in the morning; thick, red eyelids; eyelids matted together in the morning and red eyes. This condition frequently occurs in people who tend to have oily skin, dandruff, rosacea or dry eyes.
Blepharitis runs in families. It is sometimes caused by Staph or by other microbes and may be related to some skin conditions, like rosacea. The oil glands in the eyelids are abnormal and become plugged and produce an abnormal type of oil. The tears become acidic, and the tear film can break down quickly, causing dryness and burning. The inflammation produces inflammatory chemicals that irritate the entire surface of the eye. Blepharitis patients tend to get a lot of styes.
Lid margin disease cannot be cured, and will wax and wane for life. You adjust the treatment to the severity of the condition at the time. It can usually be controlled with a few simple, daily hygienic measures, such as the following:
- Once or twice per day, place a warm, wet washcloth over your closed eyelids for a couple minutes. Rewet it as it cools, two or three times. This will soften and loosen scales and debris. More important, the heat helps liquefy the thick oily secretions from the eyelids’ oil glands, and improves circulation to the inflamed area.
- With a wet Q-tip, gently scrub the base of the lashes for about 15 seconds per lid.
When medications are necessary, they may include:
- artificial tears (over-the-counter eye drops) to relieve symptoms of dry eye and acidic tears
- antibiotics (oral or topical) to decrease bacteria on the eyelids. Sometimes, low-dose oral antibiotics in the tetracycline family are good to use on a long-term basis.
- steroids (short-term), to decrease inflammation
Medications alone are not sufficient to control lid margin disease – the application of warmth and cleansing of the lashes daily is key to any treatment regimen.