19Feb

Types and treatment of blepharitis

The term "blepharitis" is used by ophthalmologists to refer to a group of diseases of the edges of the eyelids that are inflammatory in nature.

To categorize this ailment it is possible by different criteria. Different types of blepharitis are isolated based on the anatomical localization of the process, taking into account the nature of the course of the process or based on causal factors.

Acute, chronic and infectious blepharitis

Chronic blepharitis is characterized by the duration of the course and the complexity of the treatment. In order to get rid of it you often have to spend a lot of strength and patience, both to the patient himself and the treating doctor.

Causes leading to the development of inflammation of the eyelids, can become a variety of factors. In particular, infectious blepharitis develops under the action of bacteria( most often it is Staphylococcus aureus), fungi or mites. Non-infectious forms of the disease arise as a result of any eye pathology or contact with allergic agents.

Diagnosis of the described disease is based on the results of examination of eyelids and eyelashes, which is performed by a doctor using a slit lamp. Also, a complex of laboratory studies of scrapings with conjunctiva, aimed at assessing the cellular composition and microbial contamination. It has considerable significance in the diagnosis and identification of ticks in the roots of the eyelashes.

As a rule, the course of any form of the ailment under consideration is accompanied by common manifestations characteristic of the disease, including swelling and redness of the eyelids, as well as itching, rapid fatigue of the eye and the development of hypersensitivity to irritants.

Symptoms and treatment of simple blepharitis

Simple blepharitis is the easiest form of this ailment. However, in the absence of treatment, he can acquire more severe variants of the course.

With this form of inflammation, the edges of the eyelids are characterized by a slight redness and swelling. At the corners of the eyes pale grayish bubbling discharge accumulates. Another symptom is an increase in the output of the meibomian glands. Conjunctiva moderately red.

In addition, patients are concerned about burning and itching, and also increases the frequency of blinking.

Treatment of simple blepharitis is not particularly difficult. First of all, it is necessary to ensure the hygiene of the eyes: remove any crusts and wipe the eyelids daily with furicillin.

In addition to this preparation, it is possible to carry out the treatment of the eyelid edges with greenery or rub yellow mercury ointment or ointment of sulfacyl-sodium in them.

Scaly( seborrheic) blepharitis: signs and treatment

This kind of inflammation has another name - seborrheic blepharitis and is a complex disease affecting in addition to the eyelids also eyebrows, as well as the scalp.

One of the signs - the skin in the area of ​​the roots of the eyelashes with scaly blepharitis is covered with small gray-brown scales, which in their kind resemble dandruff. These scales are tightly attached to the skin, after their removal a much thinned reddened surface is exposed, and in severe cases of erosion or ulcers. The edges of the eyelids are thickened and acquire a red tinge, which is especially noticeable with exertion or eye irritation. The itching appears by evening. In some cases, a thin crust of yellowish color develops at the edges of the eyelids.

When exposed to bright light, in a dusty room, in the wind or under the influence of other external stimuli, patients report increased sensitivity of the eyes. Quickly enough, especially when using artificial lighting, fatigue develops in the eyes.

Treatment of flaky blepharitis reduces to the use of hydrocortisone ointment, which is applied to the edges of the eyelids up to 2 times a day. In parallel, a solution of zinc sulfate is added to the eye.

In addition, for this type of disease requires daily flushing of flakes by alkaline applications with subsequent cleansing of the eyelids using a green or a mixture of alcohol and ether.

Ulcerative blepharitis and its photos

Ulcerative blepharitis is by right the most severe form of inflammation of the eyelids and often develops in young people.

A special feature of this type of disease is the formation of yellowish-brownish, fairly firmly attached to the skin of the skin of the crust, at the roots of the eyelashes, the attempts to remove them cause the eyelashes to burst together with them.

Also with ulcerative blepharitis, the photo of which is located above, there is gluing of the eyelashes, pustules develop and bleeding ulcers are formed. It should be noted that ulcers of small size can merge with each other and form a ulcerous surface. As scarring occurs, the eyelashes fall out.

With this form of blepharitis, inflammation of the hair bulb is noted, the vision organs quickly become fatigued, the eyelids are swollen and red. Patients tend to experience nervous tension.

Purification of the eyelids in this form of the disease is carried out exactly as in the seborrheic variant of the disease.

The basis of treatment in this case - the use of ointments with antibiotics, for example, tetracycline or erythromycin. Selection of the ointment is carried out according to the results of the tank study.

In addition, drops are used: tsipromed or zinc sulfate, as well as ointments that include, in addition to antibacterial, corticosteroids( Dexa-Gentamicin, etc.)

Manifestations and treatment of meibomian blepharitis

In this type of illness,in the thickness of the cartilage of the eyelids of the meibomian glands. This type of disease is often accompanied by conjunctivitis. Manifestations of meibomian blepharitis differ significantly from other types of this pathology.

In this case, small translucent vesicles appear on the line of growth of the eyelashes or the upper part of the eyelid. Their removal can lead to the formation of small punctate scars in their place.

Thickened and reddened eyelids look shiny, as if they were oiled. When pressure is applied to the meibomian glands from the ducts, an oily yellow-white color is released.

There is increased lacrimation. Characterized by the appearance of maceration( swelling of the skin as a result of impregnation with its liquid).

Treatment of meibomian blepharitis is based on the restoration of normal gland function.

Usually an integral part of therapy in this case is massage. The latter is performed with the use of antiseptic( disinfecting) ointments with a glass rod. As a rule, such manipulation causes unpleasant sensations, therefore can be made under local anesthesia. Before the beginning of massage it is necessary to clear eyelids from the dried up parts of a secret that do by means of an alcoholic solution.

In the case of inflammation of the eyelid of this type, the need for surgical treatment may appear: dissection of the eyelid with scraping of meibomian glands.

Demodectic blepharitis: signs and treatment

Demodectic blepharitis is a form of inflammation of the eyelids that develops when infected with a mite Demodex folliculorum( "acne vulgaris").This type of disease can have an asymptomatic course.

Normally, this mite lives on the skin and is a representative of the skin microflora, feeding on exfoliated epidermal cells. In the case of a decrease in immunity, the number of ticks grows and a characteristic disease arises.

Symptoms of the disease in this case are reduced to itching and unpleasant sensations in the eyelids. Scaling and scales are absent. The ciliated margin is slightly hyperemic. The roots of the eyelashes are greasy.

A tick can be found in the region of the eyelid edges or at the bases of the eyelashes.

For the treatment of demodectic blepharitis, yellow mercury or zincoichthiol ointment is applied, which is applied 1-2 times / day.

Sulfapyridazine sodium, as well as norsulfazole, levomycetin and other agents that help to relieve inflammation and remove the tick, are instilled in the eye.

In addition, the lubrication of the edges of the eyelids with green or ethyl alcohol with ether is performed.

The massage of meibomian glands works well. And in order to degrease the skin, doctors recommend in the morning to wash with a cosmetic or baby soap.

Symptoms and treatment of allergic blepharitis

Allergic blepharitis

And the cause of allergic inflammation of the eyelids, as a rule, is the direct ingress of pollen, chemical substances, dust, etc. on them.

Almost immediately after contact has occurred with the allergen in the eyes of the patient appears threaded, there is a burning sensation and severe itching. The eyelids swell and become red. Another symptom - mucous discharge from the eyes and lacrimation, develops a heightened sensitivity to light. Most often, the process captures both eyes.

The chronic form of this type of disease is characterized by severe itching. In addition, the feature is a typical darkening of the skin of the eyelids, called the "allergic bruise."

To successfully combat the allergic form of blepharitis, it is first of all necessary to eliminate the effect of the substance that caused the disease. If there is no possibility to determine the allergen, then the patient is prescribed antiallergic drugs. For example, suprastin, tavegil and other antihistamines.

Another very important factor is the local use of antiallergic drugs: it is necessary to bury in the eyes lekrolin or alomir.

As an activity supplementing the main treatment, it is possible to use anti-inflammatory ophthalmic ointments( sulfanilamide or hydrocortisone).

It should be noted that with this form of the disease it can be difficult to find the right treatment. This, first of all, concerns those cases when the specific allergen leading to blepharitis is unknown. In this case, the selection of medicines is made by the method of elimination: one drug is prescribed, then, if it does not fit, another is prescribed and so on until the acting medicine is found.

Angular( angular) blepharitis

The so-called angular, and expressed in medical language, angular blepharitis, most often occurs in adolescents and is characterized by the fact that the inflammatory process in this case is localized in the corners of the eyes in which the thickening of the eyelids and the accumulation of foamy contents occur,and also appear jaundices and cracks.

In addition to this type of disease, at the site of the anatomical localization of inflammation, the marginal species of blepharitis, namely the anterior and posterior marginal blepharitis, is also distinguished. In the first case, only the edge of the eyelid is affected, in the second case, the process seizes the meibomian glands, which leads to the defeat of the connective and cornea of ​​the eye.