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Blepharitis - Complications, Diagnosis, Treatment

►What are the risk factors of Blepharitis?

Complications|
Blepharitis isn't usually serious, although it can lead to a number of further problems. If you have blepharitis, you may also experience:
Excess tearing or dry eyes. Abnormal oily secretions and other debris shed from the eyelids, such as flaking associated with dandruff, can accumulate in your tear film — the water, oil and mucus solution that forms tears. Abnormal tear film interferes with the healthy lubrication of your eyelids. This can irritate your eyes and cause symptoms of dry eyes or excess tearing.
Difficulty wearing contact lenses. Because blepharitis can affect the amount of lubrication in your eyes, wearing contact lenses may be uncomfortable.
Eyelash problems. Blepharitis can cause your eyelashes to fall out or grow abnormally (misdirected eyelashes).
Eyelid skin problems. Scarring may occur on your eyelids in response to long-term blepharitis. Or the eyelid edges may turn inward or outward.
Chalazion. A chalazion occurs when there's a blockage in one of the small oil glands at the margin of the eyelid, just behind the eyelashes. The gland can become infected with bacteria, which causes a red, swollen eyelid. Unlike a sty, a chalazion tends to be most prominent on the inside of the eyelid.
Chronic pink eye. Blepharitis can lead to recurrent bouts of pink eye (conjunctivitis).
Injury to the cornea. Constant irritation from inflamed eyelids or misdirected eyelashes may cause a sore (ulcer) to develop on your cornea. Insufficient tearing could predispose you to a corneal infection.
Sty. A sty is an infection that develops near the base of the eyelashes. The result is a painful lump on the edge (usually on the outside part) of your eyelid. A sty is usually most visible on the surface of the eyelid.

Diagnosis|
Your doctor will examine you to check if the problem is caused by an underlying condition, or may refer you to an eye specialist.
Tests and procedures used to diagnose blepharitis include:
Examining your eyelids. Your doctor will carefully examine your eyelids and your eyes. He or she may use a special magnifying instrument during the examination.
Swabbing skin for testing. In certain cases, your doctor may use a swab to collect a sample of the oil or crust that forms on your eyelid. This sample can be analyzed for bacteria, fungi or evidence of an allergy.

Treatment|
Blepharitis is usually a long-term condition. Most people experience repeated episodes, separated by periods without symptoms.
The single most important treatment principle is a daily routine of lid margin hygiene.
There are three main steps to eyelid hygiene that should be performed once or twice a day:
Using a warm compress – to make the oil produced by the glands around your eyes more runny
Gently massaging your eyelids – to push the oils out of the glands
Cleaning your eyelids – to wipe away any excess oil and remove any crusts, bacteria, dust or grime that might have built up
If that is not enough, your doctor may suggest prescription treatments, including:
Medications that fight infection.
Antibiotics applied to the eyelid have been shown to provide relief of symptoms and resolve bacterial infection of the eyelids. These are available in a variety of forms, including eyedrops, creams and ointments. If you don't respond to topical antibiotics, your doctor may suggest an oral antibiotic.
Medications to control inflammation.
Steroid eyedrops or ointments may help control inflammation. Your doctor may prescribe both antibiotic and anti-inflammatory drugs.
Medications that affect the immune system.
Topical cyclosporine (Restasis) is a calcineurin inhibitor that has been shown to offer relief of some signs and symptoms of blepharitis.
Treatments for underlying conditions.
Blepharitis caused by seborrheic dermatitis, rosacea or other diseases may be controlled by treating the underlying disease.
Blepharitis rarely disappears completely.

Even with successful treatment, the condition frequently is chronic and requires daily attention with eyelid scrubs. If you don't respond to treatment, or if you've also lost eyelashes or only one eye is affected, the condition could be caused by a localized eyelid cancer.

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