Blepharitis/Dry eyes & COVID-19

What is Blepharitis/Dry eye?

Blepharitis is inflammation of the rims of the eyelids, which causes them to become red and swollen.

Dry eyes occur when your lacrimal gland, which is found under the socket below the eyebrow, does not secrete enough tears.

Dry eyes and blepharitis can be considered two extremes of the same condition.  People who have dry eyes will develop a degree of blepharitis and eyes suffering from blepharitis will feel dry.

It is a common condition which can develop at any age but is more common in young children and people over 50. Most people experience repeated episodes followed by periods with no symptoms. It is not possible to catch blepharitis or dry eyes from someone else who has it.

Blepharitis/Dry eye is usually a long-term (chronic) condition, which means once it develops it can cause repeated episodes.

What does Blepharitis/Dry eye feel like?

The symptoms of blepharitis/dry eye can include burning, soreness or stinging in the eyes; crusty eyelashes and itchy eyelids. It can also cause lid cysts (chalazion). The cause is not known in most cases but, although it is not an infection, it can be caused by a reaction to the bacteria that live naturally on the eyelid skin.  It is more common in skin conditions such as:

Seborrhoeic dermatitis, which causes an itchy rash on the skin and scalp (seborrhoeic dermatitis of the scalp is called dandruff)

Rosacea which causes the face to appear red and blotchy

Acne in teenager and young adults, which causes irritation and blockage of the glands in the centre of the face

Blepharitis/Dry eye is not usually serious but can produce a lot of symptoms and can make people unable to wear contact lenses comfortably.

The hormonal changes experienced by ladies during the menopause can often lead to less tear secretion and start the symptoms of dry eyes.

Many people with blepharitis also have dry eye condition where the eyes do not produce enough tears or dry out too quickly.

Serious complications, such as sight loss, are rare, particularly if recommended advice is followed.

More severe cases of blepharitis/dry eye may require treatment with antibiotic ointment applied to the eyelids or, antibiotic drops for the eyes and, in a few cases, steroid eye drops.

Some patients benefit from antibiotics by mouth, particularly when the blepharitis is associated with a skin condition such as rosacea. These antibiotics are usually required for at least four to six weeks and may need to be continued for many months.  These can be prescribed by Mr Ursell if required.

Treatment of Blepharitis/Dry eyes

There is no cure for blepharitis/dry eye but establishing a daily eyelid-cleaning routine can help control the symptoms and any dryness can be treated with artificial tear drops. Lid cleaning often needs to be continued indefinitely to prevent a recurrence.  Treatment involves, lubricating drops, hot compresses and vitamin supplements.  Each person will require different levels of each, and you should experiment to find out which combination works best for your own symptoms.

Lubricating drops are the mainstay of treatment.  There are many different drops available often without a prescription.  You should try a selection and use the one that feels most soothing to your own eyes.  Some people find that they prefer different drops at different times of the day.

Tips for choosing the correct drop

There has been a lot of research performed to see if we can find ways of helping people find the best drop for their own particular set of symptoms.  So far none have been able to improve on simply asking people to try out a selection and use whichever feels best for them.  It is for this reason when asked for a particular drop to recommend as best, Mr Ursell will always suggest trying out a selection rather than naming a particular product.

Once you have found a particular drop or set of drops which feel most comfortable it is vital that you use them frequently and regularly.  Lubricating drops work best to prevent irritation in your eyes rather than once the eye has become very sore and irritated.  One of the most common problems Mr Ursell finds is that patients are not using their drops frequently enough to control their symptoms.

If your eyes are sore during the night or are irritated on waking in the morning a thicker, long lasting cream such as Hylo-night or Lacrimal-Lube used before sleeping can be useful.

More severe cases of blepharitis/dry eye may require treatment with antibiotic ointment applied to the eyelids or, antibiotic drops for the eyes and, in a few cases, steroid eye drops.

Hot Compresses

You should try to see whether a hot compress once or twice a day helps.  A simple method is to soak a flannel or small towel in hot water, squeeze it out and place it over your closed eyes.  After it has been in place for about 5 minutes remove it and massage the glands in the eyelid towards the eyelashes.  If you find this helpful you can buy specific EyeBags which are heated in the microwave.

Omega 3 Vitamins

These vitamins help the health of the glands in the skin and eyelids which may be part of the problem in Blepharitis/Dry eyes.  They are found naturally in oily fish such as mackerel or tuna.  You can take supplements which are available in health food stores.

The recommended method is to take supplements daily for two months then stop.  If your eyes feel worse after stopping, then the vitamins have been helping and you should restart them.  This occurs in about 50% of patients.

Omega 6 is found in margarine and competes with Omega 3 for absorption in the stomach so to help the beneficial Omega 3 you should switch from margarine to butter if your cholesterol regime allows.

For more information about blepharitis/dry eyes please see here:

https://www.allaboutvision.com/en-gb/conditions/dry-eye-syndrome/

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