Blepharitis

Blepharitis: What You Should Know

If you are experiencing inflammation of the eyelids, you might be suffering from a condition called blepharitis. Blepharitis can be caused by a number of different factors, including bacteria, mite infestations (condition know as Demodex), or overproduction of eye oils. Chronic blepharitis can be painful and the resulting eye dryness can often lead to blurred vision, eye pain, and even ulcerations of the cornea.  In a skilled nursing home facility, it’s very common for patients to be non-verbal, thus making it difficult for them to verbalize their discomfort or visual complaints.  For this reason, and the common conditions listed above, it’s recommended that all nursing home patients be examined at least once a year by an eye care professional.    

Causes of Blepharitis 

-Malfunctioning of the meibomian eyelid oil glands
-Seborrheic dermatitis (dandruff of the scalp and eyebrows)
-Acne rosacea (a skin condition that causes redness of the face)
-Eyelash mites (also known as Demodex)
-Allergic reactions to cosmetics or medications


Red puffy eyelid margins resulting in burning eyes are some of the main symptoms patients notice in blepharitis.  Patients also can have watery or red eyes, crusting of the eyelids, and eyelids that are sticky or itchy. The skin around the eyelids may begin to flake, while the patient may report having a gritty or burning sensation on the surface of their eye. Because of this, they may frequently blink and experience light sensitivity.  Having blepharitis also contributes to Dry Eye Syndrome and the signs and symptoms of each often overlap.  

Treatment of Blepharitis

Treatment of blepharitis is fairly straightforward and depends on the type you have.  Anterior blepharitis is primarily found on the lid margins where the eye lashes are located.  In posterior blepharitis the meibomian glands located within the eyelid become clogged and inflamed.  This is very common in patients who have the skin condition known as rosacea.  If the cause is due to Demodex, lid scrubs with tea tree oil are recommended to eradicate the mite infestation.  Oral antibiotics and topical antibiotic/steroid ointments are also often used when treating severe cases of blepharitis.  As patients often have concurrent dry eye symptoms, topical ocular lubricants are also often prescribed.  

Blepharitis in Nursing Homes

Even though blepharitis can occur at any age, people in nursing homes are particularly susceptible. This is because the elderly are less able to perform daily hygiene tasks on their own, such as cleaning their eyelids and washing their face. This gives bacteria and Demodex an ideal environment to grow and reproduce. This is one of the most common conditions we see in our elderly patients and can lead to chronic redness and discomfort.  Luckily, if diagnosed and treated correctly, signs and symptoms from blepharitis can be greatly improved in a few short weeks.  

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