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Blepharitis/Meibomianitis 

The term blepharitis or meibomianitis refers to inflammation of the lid margin.

It can affect all ages but is particularly common later in life. 

In meibomianitis the site of inflammation is the eyelid glands producing the oily material required for a healthy tear film. These glands are either not producing the right amount or producing an abnormal oily layer.   As a result the tears evaporate quickly and the patient develops symptoms of dry, gritty eyes.  To compensate for rapid evaporation of tears, the tear gland produces too many tears.  This results in watery eyes as well as a gritty dry feeling.  

In blepharitis the site of inflammation is slightly anterior in the lid margin around the lashes. The lid margin is scaly and there is often loss of lashes or lashes are abnormally curved in rubbing on the surface of the eye. There is also an itchy, sticky feeling around the lid margin particularly in the morning and lids are sometimes difficult to open.  Blepharitis and meibomianitis often coexist. 

Occasionally patients with meibomianitis have what is called acne rosacea.  These patients develop a bluish tint to the nose and have a rather flushed rosy face.  This flushing is exaggerated with drinking a glass of wine, eating spicy food or exposure to the sun. 

How blepharitis is treated: 

Most people with this condition do not need treatment if they are asymptomatic.   It is important to know that blepharitis/meibomianitis is not  a serious condition, but is a nuisance.  Very rarely however it can affect the eye inducing corneal ulcers and equally important is to note that this condition is not curable, but can be brought under reasonable control. 

Lid hygiene:  

This is best done when in the shower and needs to be done twice a day in severe cases.   Boil some water and put a cotton bud in the boiled water.  Apply a drop of neat baby shampoo to the tip of the cotton applicator and stand in front of the mirror and scrub the bottom of the lashers with the cotton bud for about two minutes.  Both upper and lower lids need to be cleaned.  Dilute the baby shampoo if you prefer.  Alternatively you can put a tea spoonful of bicarbonate soda in a pint of boiled water and apply in the same manner as the baby shampoo. 

If your doctor has suggested an antibiotic scrub, take another bud and apply the antibiotic to the bud and scrub it into the lid margin.  Your doctor might suggest other treatments such as oral antibiotics or a short course of steroid drops.  You need to use the lid scrub long life and use the artificial drops as and when required.

Eye soaks/heat  treatment:   

Boil some water and put a tea spoonful of bicarbonate soda in a pint of boiled water.  Take two pieces of cotton wool and soak with water and put on your eyes with head tiled back.   Allow the water to soak into the eye.