Blepharitis & Chalazion

Blepharitis (Lid Margin Disease)
Lid margin disease is a common and frequently chronic inflammation of the eyelids (blepharitis). Symptoms include irritation, itching, and, occasionally, a red eye. This condition frequently occurs in people who tend to have oily skin, dandruff, or dry eyes.  Bacteria normally reside on the skin, but in some people, they thrive in the skin at the base of the eyelashes. Nearby oil glands may be overactive, causing dandruff-like scales and particles to form along the lashes and eyelid margins, which can cause redness, stinging, or burning.

 

Meibomian Gland Dysfunction:    

Meibomian gland dysfunction, as seen above, can also contribute to lid margin disease.  The Meibomian glands are sebaceous glands that produce the oil layer of your tear film.  The openings to the glands are just behind the eyelashes, and abnormal oil goblets can be seen in the photo above in a person with lid margin disease. 
Lid margin disease cannot be cured, but it can be controlled with a few simple, daily hygienic measures, such as the following:

  • At least twice a day, place a warm, wet washcloth over your closed eyelids for a minute. Rewet it as it cools, two or three times. This will soften and loosen scales and debris. More important, it helps liquefy the oily secretions from the eyelids' oil glands, which helps prevent the development of a chalazion, an inflamed lump in an eyelid oil gland.
  • With your finger covered with a thin, wet washcloth, cotton swab, or commercial lint-free pad, gently scrub the base of the lashes for about 30 seconds per eyelid.  It may help to use dilute baby shampoo (1 part shampoo to 3-4 parts water, just a few drops in the bottle cap) for scrubbing.

When medications are necessary, they may include:

  • artificial tears (over-the-counter eyedrops) to relieve symptoms of dry eye;
  • antibiotics (oral or topical or both) to decrease bacteria on the eyelids; and
  • steroids (short-term), to decrease inflammation.

Medications alone are not sufficient to control lid margin disease; the application of warmth and detailed cleansing of the lashes daily is the key.

Chalazion

A chalazion is a large bump (swelling) in the eyelid caused by inflammation of one of the small oil-producing glands located in the upper and lower eyelids. A chalazion is sometimes confused with a stye, which also appears as a lump in the eyelid. However, a stye is an infection of a lash follicle and forms a red, sore lump. Chalazia tend to occur farther from the edge of the eyelid than a stye, and tend to œpoint toward the inside of the eyelid. Sometimes a chalazion can cause the entire eyelid to swell suddenly, but usually there is a particular tender point.

Chalazion:
      

When a chalazion is small and without symptoms, it may disappear on its own. If the chalazion is large, it may cause blurred vision. Chalazia are treated with any or a combination of the following methods:

  • Warm compresses help to clear the clogged gland (2 hours daily or 8-10 x daily for 10-15 minutes);
  • Antibiotic ointments may be prescribed if bacteria infect the chalazion;
  • Steroid injections may be used to reduce inflammation;
  • Surgery may be used to drain a large chalazion if it does not respond to other treatments. The procedure is usually performed under local anesthesia in Dr. Haas's office.

Chalazia usually respond well to treatment, although some people are prone to recurrences. If a chalazion recurs in the same place, Dr. Haas may suggest a biopsy to rule out problems that are more serious.