Ocular Surface Disease
What is Blepharitis?
Blepharitis is a very common inflammatory condition of the lid margin. It is caused by an abnormality of the glands at the base of the eyelash follicles. People with this condition experience any or all of the following symptoms:
- eye irritation: gritty, itching, burning, tired
- eye redness
- reflex watering of the eyes especially when reading or driving
- blurry vision, fluctuating vision
- corneal ulceration(rarely)
What can I do about my Blepharitis?
Blepharitis is very common, especially with increasing age. While the symptoms are frustrating, it is important to know that it is rarely damaging to the eye.
Unfortunately the condition cannot be cured, and treatment is aimed at alleviating the various symptoms in order to improve comfort.
To relieve your symptoms you should:
- Lubricate the eyes regularly. This soothes the burning sensation that is commonly experienced by sufferers and dilutes the toxic bacterial by-products that accumulate in the tear film. Dr. Kert will give you a sample lubricant to take home. There are many lubricants on the market and it is a matter of trial and error to find one that suits you. Remember that the lubricant will only ease your symptoms for a short while. Lubricants will help with ocular irritation and with reflex watering too.
- Cleaning the lid margin is the mainstay of treatment. You can do this with a cotton bud dipped in a solution of bicarbonate of soda and water. It helps to do this in front of the mirror at first, addressing both upper and lower lids on each side.
You can make the solution yourself by mixing one cup of boiled water (that has cooled) with 1/2 teaspoon of bicarbonate of soda. Leave the solution in the fridge to use for a few days at a time.
You can also try Johnson’s Baby Shampoo and water, or buy commercially available products such as LIDCARE or STERILID from your pharmacist if you prefer.
It is important that you clean the eyelid margin thoroughly, aiming for the roots of the eyelashes. This removes excess debris, oil and bacteria from this area which helps to settle the condition down.
It is better to clean your lid margins twice a day when your blepharitis has flared, and taper after two weeks. Try to do it after a shower as the warm water helps the oily meibomian glands at the lid margin to discharge and enables a more thorough clean.
- IPL for dry eye is a pulsed light therapy that has been shown to improve symptoms in 80% of patients suffering dry eye. It is applied to the lower eyelid skin over three or four treatment sessions performed in Dr Kert's treatment room. Each treatment takes approximately 15 minutes and has minimal side effects. Ask our staff for more information.
Remember that these measures will help alleviate your symptoms but will not cure the condition for you.
Contact the team at Darling Downs Eye if you have any further questions.
Dry eye syndrome is one of the most common problems treated by eye physicians. It is usually caused by a problem with the quality of the tear film that lubricates the eyes.
Tears are comprised of three layers. The mucin layer coats the cornea, the eye’s clear outer window, forming a foundation so the tear film can adhere to the eye. The middle aqueous layer provides moisture and supplies oxygen and other important nutrients to the cornea. This layer is made up of 98 percent water along with small amounts of salt, proteins and other compounds. The outer lipid layer is an oily film that seals the tear film on the eye and helps to prevent evaporation.
Tears are formed in several glands around the eye. The water layer is produced in the lacrimal gland, located under the upper eyelid. Several smaller glands in the lids make the oil and mucus layers. Excess tears flow into two tiny drainage ducts in the corner of the eye by the nose. These ducts lead to tiny canals that connect to the nasal passage. The connection between the tear ducts and the nasal passage is the reason that crying causes a runny nose.
In addition to lubricating the eye, tears are also produced as a reflex response to outside stimulus such as an injury or emotion. However, reflex tears do little to soothe a dry eye, which is why someone with watery eyes may still complain of irritation.
Dry eye syndrome has many causes. One of the most common reasons for dryness is simply the normal ageing process. As we grow older, our bodies produce less oil - 60% less at age 65 then at age 18. This is more pronounced in women, who tend to have drier skin than men. The oil deficiency also affects the tear film. Without as much oil to seal the watery layer, the tear film evaporates much faster, leaving dry areas on the cornea.
Many other factors, such as hot, dry or windy climates, high altitudes, air-conditioning and cigarette smoke may also cause dry eyes. Many people also find their eyes become irritated when reading or working on a computer. Stopping periodically to rest and blink keeps the eyes more comfortable.
Contact lens wearers may also suffer from dryness because the contact absorbs the tear film, causing proteins to form on the surface of the lens. Certain medications, thyroid conditions, vitamin A deficiency, and diseases such as Parkinson’s disease and Sjogren’s syndrome can also cause dryness. Women frequently experience problems with dry eyes as they enter menopause because of hormonal changes.
- Blurred vision that improves with blinking
- Excessive tearing
- Increased discomfort after periods of reading, watching TV or working on a computer.
When it comes to treating dry eyes, everyone’s needs are a little different. Many find relief simply from using artificial tears on a regular basis. Some of these products are watery and alleviate the symptoms temporarily; others are thicker and adhere to the eye longer. Preservative-free tears may be recommended because they are often the most soothing and have fewer additives that could potentially irritate the ocular surface.
Avoid products that whiten the eyes - they don’t have adequate lubricating qualities and often make the problem worse.
Closing the opening of the tear drain in the eyelid with special inserts called punctal plugs is another option. This works like closing a sink drain with a stopper. These special plugs trap the tears on the eye, keeping it moist. There are other treatments available that Dr Kert may discuss with you.
There are also simple lifestyle changes that can significantly improve irritation from dry eyes. Make a conscious effort to blink frequently - especially when reading or watching television. Avoid rubbing the eyes. This worsens the irritation. Remember that while the condition is irritating, it does not usually compromise the health or function of the eye as a whole.
IPL for dry eye is a pulsed light therapy that has been shown to improve symptoms in 80% of patients suffering dry eye. It is applied to the lower eyelid skin over four treatment sessions performed in Dr Kert's treatment room. Ask our staff for more information.
IPL (Intense Pulsed Light) technology has been around for many years to treat cutaneous hemangiomatous (red) lesions on the face. The treatment was incidentally found to improve dry eye symptoms in patients with meibomian gland dysfunction (dry eye).
- Dry eye affects 20% of the population.
- Current treatments are varied and mostly ineffective leading to frustration for both treating physicians and patients.
- IPL has been shown to significantly improve dry eye symptoms after 4 treatments in 86% of patients. (A /Professor J Craig Auckland Investigative Ophthalmology and Visual Sciences ,2014)
- Treatment effect is sustained for 3-6 months depending on severity, and the treatment can be repeated safely as needed.
- The treatment is painless and in trained hands has not been linked to any adverse effects.
- Cost of treatment will be discussed at the time of making the appointment.
For more information please contact the team at Darling Downs Eye.