Blepharitis

The doctor has diagnosed blepharitis.  This is a very common inflammation involving the eyelashes and eyelids.  For some patients the inflammation is caused by a low grade infection in the eyelash follicles, while in others it is caused by a malfunction of the oil secreting glands of the eyelids.  The symptoms of blepharitis typically result from disruption of the normal balanced tear film.  There may be burning and stinging, or blurring of vision that comes and goes and seems to sometimes be affected by blinking.  Often this seems to be more of a problem in the morning.  Some patients wake up with lots of “sleep” in their eyes, mattering, or the lids stuck together.  Some patients have reddened eyelid rims.  Treatment is based on the underlying problem and its severity.  Many patients have mild blepharitis that is not causing any symptoms and they do fine with no treatment.  Others have some symptoms that may come and go, and simply using lid scrubs in the morning is all that is needed.  For patients that have a greater problem it may be necessary to use antibiotic eye drops or ointments.  For severe cases, especially with associated styes, antibiotics by mouth may be the preferred treatment.

In your case the doctor recommends:

Lid Scrubs: Use a warm, moist washcloth.  Try to have the washcloth as warm as you can stand.  Close the eyes and gently work along the lashes with a rubbing motion from the nose side going outwards.  This should be done every morning. Some patients prefer commercially prepared eye scrub pads and these are fine as a substitute for the washcloth. They are available without a prescription at any drugstore.

Antibiotic Eye drops: In some cases your doctor may have reason for using antibiotic eyedrops instead of ointments.  Typically the drops will be used for a week or two to reduce the amount of bacteria on the lids.   Drops are normally instilled while lying down with the eyes closed so the they can have maximum contact with the problem area — the eyelid and lashes.  If some of the drops get in the eye it is not a problem.  Use the drops as indicated on the instructions from the pharmacy.  Blepharitis almost always affects both eyes — even if the symptoms seem to affect one eye more.  Usually both eyes are treated.

Antibiotic Ointments: Often blepharitis can be managed with an antibiotic or antibiotic/steroid ointment applied to the closed eyelids at bedtime.  The medicine, in ointment form, stays in contact with the area to be treated throughout the night.  Sometimes it is necessary to use the ointment during the day as well, however ointments can blur the vision a bit as they are much thicker than eye drops.  As with the drops, ointments are used every night for no longer than 1-2 weeks, then replaced with just the morning lid scrubs.

Oral Antibiotics: Sometimes these are used for 1-2 weeks and occasionally doxycycline can be used on a long term basis — 2-6 mos.  Follow the directions on the medication.  The doctor will ask to make sure you do not have any allergies to any of the components.

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