Itchy Eyelashes: Causes, Treatments, and Prevention

Don’t rub it in

Many conditions can cause your eyelashes and eyelash line to feel itchy. If you’re experiencing itchy eyelashes, it’s important not to scratch as this can further irritate or possibly infect the area.

The underlying cause of itchy eyelashes is often some type of external irritant. Sometimes it’s a health condition. The cause will determine how you should treat it. Some treatments will require a doctor’s care but others can be treated at home.

There are many potential causes of itchy eyelashes. Here are seven possible reasons.

Allergies

Eyelid dermatitis can be caused by an allergic reaction. It can happen in one or both eyes. This condition causes:

• itching of the eyelids and eyelashes
• redness
• scaly skin
• swelling

It’s possible to be allergic to ingredients found in many products you use on, near, or in your eye. These products include:

• eye and face makeup
• shampoo
• contact lens solution
• medications for conditions such as glaucoma

You can also get itchy eyelids from products you use and touch with your hands if you then touch your eyes.

Allergies can be tricky. Sometimes, you’ll realize you’re allergic to a new product right away. Other times, a tried-and-true cosmetic will suddenly become responsible for itching in your eyelashes and eyelid margins – the area of the eye where your eyelash follicles grow.

Allergies to products sometimes become worse as your exposure to them increases. This can also happen with eye drop medications.

Allergic conjunctivitis

Itchy eyelashes and eyes can be caused by seasonal or year-round allergens. Seasonal allergens include pollen and ragweed. Year-round allergens include dust, dust mites, and mold.

Your body reacts to these irritating substances by producing histamine in the eye tissues, causing extreme itching, swelling, and redness.

Blepharitis

This chronic condition affects the area of the eyelid where your eyelashes grow and typically occurs in both eyes simultaneously. There are two types:

• anterior blepharitis, which affects the outside edge of your eyelid where eyelashes grow
• posterior blepharitis, which affects the inner edge of your eyelid where your eyeball comes in contact with the eyelid

Blepharitis can have many causes, including:

• bacterial infections
• eyelash mites or lice
• allergies
• seborrheic dermatitis
• clogged oil glands

It causes itching, burning, and swelling. This condition can also cause your eyelashes to fall out or to grow in a slanted direction.

Stye

A stye, also known as a hordeolum, is a hard bump that might appear suddenly in your lash line. They often resemble pimples and can range in size from small to large. Styes are often caused by an infection in an eyelash follicle. Styes can be itchy and painful or may simply be visible without pain.

Dry eye syndrome

This condition occurs when your eyes don’t produce enough tears to keep them lubricated. This can cause itching. Inadequate tear production can also lead to an accumulation of foreign matter in the eyes, which might further irritate or infect them, causing additional itching to occur.

Phthriasis palpebrarum

This rare eye condition is caused by an infestation of lice, which are more typically found in the pubic region or other areas of the body. While rare in eyelashes, it can cause intense itching. This condition may be mistaken for blepharitis.

Conjunctivitis

An eye infection like conjunctivitis, known as pinkeye, is highly contagious. It can occur in one or both eyes. Pinkeye can be caused by a viral or bacterial infection. It causes itching, a gritty feeling under the eyelid, redness, and swelling.

Itching in the eye area can feel localized, occurring only in the lash line. The feeling can also extend to your entire eye or eyelid. Based on the cause, other symptoms can also be associated with itchy eyelashes. These include:

• abrupt change in or loss of vision
• eye discharge
• eye pain
• greasy skin on the eyelids
• gritty or burning sensation in or around the eye
• red skin on and around the eye
• scaly or flaking skin
• swelling of the eyelid and under the eye area

There are a number of treatments you can try at home. These include:

• Antihistamines. Over-the-counter allergy eye drops work by reducing the amount of histamine in the eye. You can try using these on their own or combine them with an oral antihistamine.
• Cleansing. Keeping your eyelids clean can be beneficial in all cases. Don’t use a drying soap, especially if you have dermatitis. If you have blepharitis, massage your eyelids gently with a cloth to stop oil from gathering in your eyelid glands. You can also try gently washing your lids with diluted baby shampoo or an eyelid cleanser designed for this purpose.
• Corticosteroid creams. Some of these creams, such as 0.5 to 1 percent hydrocortisone, are mild enough for use on your eyelid. These may help alleviate itching caused by eyelid dermatitis. Don’t use strong products, as these can thin the skin of the eyelid. Make sure you don’t get the cream into your eye.
• Liquid tears. These eye drops can also help reduce itching caused by conjunctivitis and dry eye syndrome.
• Moisturize the area. Use an unscented moisturizer to soothe and nourish eyelid skin, especially if you have dermatitis.
• Warm or cool compresses. If you have a stye or viral conjunctivitis, warm compresses can help soothe the area, helping it heal. Warm compresses can also be beneficial for removing any crusts caused by blepharitis. Applying a warm compress can help encourage excess fluid to circulate out of your eyelid area.

There are several strategies you can try for preventing itchy eyelashes. Here are eight things you can try:

• Clean your bedding and towels often.
• Discard eye makeup and eye products older than six months.
• Don’t share your makeup or use store testers on your face or eyes.
• If you wear contact lenses, give your eyes a break for a few days by wearing glasses. If this isn’t possible, make sure to cleanse your lenses often or switch to daily wear lenses and replace your contact lens case.
• Keep your eyelids and the surrounding area clean, including going makeup-free if possible for a few days.
• Try not to rub or touch your eyes with your hands to prevent the introduction of allergens to the area.
• Try switching your current makeup for hypoallergenic varieties.
• Try to identify the products that may be causing your itchy eyelids. Try eliminating one product or ingredient at a time for one to two days. Or, eliminate all products and slowly reintroduce each item one at a time.

Itchy eyelashes may respond to at-home treatments within a few days. If the itching doesn’t go away easily, gets worse, or returns, you should consult a doctor. Also, be sure to see your doctor if itching is uncontrollable or causing you distress.

Make an appointment with your doctor if the itching is accompanied by other symptoms such as:

• pain in your eye area
• blurriness in your vision
• oily, scaly skin on your eyelids
• swelling
• redness

If at-home treatments don’t work, your doctor can evaluate and diagnose your symptoms, providing treatment, and hopefully, faster relief.

To determine what’s causing the itch, your doctor will try to uncover allergens in your products or environment which might be causing the problem.

You might also be given a test for allergic substances, such as a patch test. This test introduces possible irritants to your skin via adhesive patches to see which ones you react to.

Your doctor will look at your eye for signs of infection. If they suspect blepharitis, you may have a swab test of your eyelid done. This will remove scabs and oil from the eyelid so they can be analyzed for allergens, bacteria, or fungi in the laboratory.

For some conditions, such as bacterial conjunctivitis, your doctor may prescribe an antibiotic eye drop.

Itching eyelashes can be caused by a wide range of conditions, including allergens and irritants in the environment. Itching and discomfort can often be treated at home. When itching is severe, doesn’t resolve easily, or is accompanied by other symptoms, like eye pain, seeing a doctor can help.

Itchy Eyelashes: Causes, Treatments, and Prevention

Don’t rub it in

Many conditions can cause your eyelashes and eyelash line to feel itchy. If you’re experiencing itchy eyelashes, it’s important not to scratch as this can further irritate or possibly infect the area.

The underlying cause of itchy eyelashes is often some type of external irritant. Sometimes it’s a health condition. The cause will determine how you should treat it. Some treatments will require a doctor’s care but others can be treated at home.

There are many potential causes of itchy eyelashes. Here are seven possible reasons.

Allergies

Eyelid dermatitis can be caused by an allergic reaction. It can happen in one or both eyes. This condition causes:

• itching of the eyelids and eyelashes
• redness
• scaly skin
• swelling

It’s possible to be allergic to ingredients found in many products you use on, near, or in your eye. These products include:

• eye and face makeup
• shampoo
• contact lens solution
• medications for conditions such as glaucoma

You can also get itchy eyelids from products you use and touch with your hands if you then touch your eyes.

Allergies can be tricky. Sometimes, you’ll realize you’re allergic to a new product right away. Other times, a tried-and-true cosmetic will suddenly become responsible for itching in your eyelashes and eyelid margins – the area of the eye where your eyelash follicles grow.

Allergies to products sometimes become worse as your exposure to them increases. This can also happen with eye drop medications.

Allergic conjunctivitis

Itchy eyelashes and eyes can be caused by seasonal or year-round allergens. Seasonal allergens include pollen and ragweed. Year-round allergens include dust, dust mites, and mold.

Your body reacts to these irritating substances by producing histamine in the eye tissues, causing extreme itching, swelling, and redness.

Blepharitis

This chronic condition affects the area of the eyelid where your eyelashes grow and typically occurs in both eyes simultaneously. There are two types:

• anterior blepharitis, which affects the outside edge of your eyelid where eyelashes grow
• posterior blepharitis, which affects the inner edge of your eyelid where your eyeball comes in contact with the eyelid

Blepharitis can have many causes, including:

• bacterial infections
• eyelash mites or lice
• allergies
• seborrheic dermatitis
• clogged oil glands

It causes itching, burning, and swelling. This condition can also cause your eyelashes to fall out or to grow in a slanted direction.

Stye

A stye, also known as a hordeolum, is a hard bump that might appear suddenly in your lash line. They often resemble pimples and can range in size from small to large. Styes are often caused by an infection in an eyelash follicle. Styes can be itchy and painful or may simply be visible without pain.

Dry eye syndrome

This condition occurs when your eyes don’t produce enough tears to keep them lubricated. This can cause itching. Inadequate tear production can also lead to an accumulation of foreign matter in the eyes, which might further irritate or infect them, causing additional itching to occur.

Phthriasis palpebrarum

This rare eye condition is caused by an infestation of lice, which are more typically found in the pubic region or other areas of the body. While rare in eyelashes, it can cause intense itching. This condition may be mistaken for blepharitis.

Conjunctivitis

An eye infection like conjunctivitis, known as pinkeye, is highly contagious. It can occur in one or both eyes. Pinkeye can be caused by a viral or bacterial infection. It causes itching, a gritty feeling under the eyelid, redness, and swelling.

Itching in the eye area can feel localized, occurring only in the lash line. The feeling can also extend to your entire eye or eyelid. Based on the cause, other symptoms can also be associated with itchy eyelashes. These include:

• abrupt change in or loss of vision
• eye discharge
• eye pain
• greasy skin on the eyelids
• gritty or burning sensation in or around the eye
• red skin on and around the eye
• scaly or flaking skin
• swelling of the eyelid and under the eye area

There are a number of treatments you can try at home. These include:

• Antihistamines. Over-the-counter allergy eye drops work by reducing the amount of histamine in the eye. You can try using these on their own or combine them with an oral antihistamine.
• Cleansing. Keeping your eyelids clean can be beneficial in all cases. Don’t use a drying soap, especially if you have dermatitis. If you have blepharitis, massage your eyelids gently with a cloth to stop oil from gathering in your eyelid glands. You can also try gently washing your lids with diluted baby shampoo or an eyelid cleanser designed for this purpose.
• Corticosteroid creams. Some of these creams, such as 0.5 to 1 percent hydrocortisone, are mild enough for use on your eyelid. These may help alleviate itching caused by eyelid dermatitis. Don’t use strong products, as these can thin the skin of the eyelid. Make sure you don’t get the cream into your eye.
• Liquid tears. These eye drops can also help reduce itching caused by conjunctivitis and dry eye syndrome.
• Moisturize the area. Use an unscented moisturizer to soothe and nourish eyelid skin, especially if you have dermatitis.
• Warm or cool compresses. If you have a stye or viral conjunctivitis, warm compresses can help soothe the area, helping it heal. Warm compresses can also be beneficial for removing any crusts caused by blepharitis. Applying a warm compress can help encourage excess fluid to circulate out of your eyelid area.

There are several strategies you can try for preventing itchy eyelashes. Here are eight things you can try:

• Clean your bedding and towels often.
• Discard eye makeup and eye products older than six months.
• Don’t share your makeup or use store testers on your face or eyes.
• If you wear contact lenses, give your eyes a break for a few days by wearing glasses. If this isn’t possible, make sure to cleanse your lenses often or switch to daily wear lenses and replace your contact lens case.
• Keep your eyelids and the surrounding area clean, including going makeup-free if possible for a few days.
• Try not to rub or touch your eyes with your hands to prevent the introduction of allergens to the area.
• Try switching your current makeup for hypoallergenic varieties.
• Try to identify the products that may be causing your itchy eyelids. Try eliminating one product or ingredient at a time for one to two days. Or, eliminate all products and slowly reintroduce each item one at a time.

Itchy eyelashes may respond to at-home treatments within a few days. If the itching doesn’t go away easily, gets worse, or returns, you should consult a doctor. Also, be sure to see your doctor if itching is uncontrollable or causing you distress.

Make an appointment with your doctor if the itching is accompanied by other symptoms such as:

• pain in your eye area
• blurriness in your vision
• oily, scaly skin on your eyelids
• swelling
• redness

If at-home treatments don’t work, your doctor can evaluate and diagnose your symptoms, providing treatment, and hopefully, faster relief.

To determine what’s causing the itch, your doctor will try to uncover allergens in your products or environment which might be causing the problem.

You might also be given a test for allergic substances, such as a patch test. This test introduces possible irritants to your skin via adhesive patches to see which ones you react to.

Your doctor will look at your eye for signs of infection. If they suspect blepharitis, you may have a swab test of your eyelid done. This will remove scabs and oil from the eyelid so they can be analyzed for allergens, bacteria, or fungi in the laboratory.

For some conditions, such as bacterial conjunctivitis, your doctor may prescribe an antibiotic eye drop.

Itching eyelashes can be caused by a wide range of conditions, including allergens and irritants in the environment. Itching and discomfort can often be treated at home. When itching is severe, doesn’t resolve easily, or is accompanied by other symptoms, like eye pain, seeing a doctor can help.

Itching of the eyelids – causes and treatment in the MHC

Causes of itching

Actually, itching that occurs in the eyes or eyelids is not an independent pathology. This is just one of the manifestations of some diseases. Moreover, there are quite a lot of conditions that contribute to the appearance of such unpleasant sensations. Among them:

• foreign body in the eye
• healing eye and eyelid injuries
• manifestations of allergy
• corneal ulcers
• blepharitis
• eye involvement with stye, meibomite, abscess
• demodicosis eye, eyelid
• conjunctivitis
• dry eye
• keratitis

The most common cause of itchy eyes is a foreign body. However, depending on the nature of this agent, there are quite a few reasons for seeking medical help. After all, you should not rub your eye or try to remove the interfering object on your own. Such actions, as a rule, only exacerbate the situation. Only a timely appeal to a specialized medical institution will help prevent negative consequences.

Healing of injuries to the eyes or eyelids, especially after surgery, can also cause itching. These are manifestations of the process by which the body gets rid of dead tissue. The eyelids and eyes are itchy and the person blinks frequently. This condition is normal and should not cause concern.

Allergies are another common cause of itchy eyes. Allergens can be household chemicals, decorative or medical cosmetics, ordinary dust, as well as plant pollen and poplar fluff. Itching of the eyes, accompanied by swelling and redness, can become a symptom of a systemic allergy (allergic rhinitis, atopic dermatitis). To remove these unpleasant symptoms, you need to consult an allergist who can professionally find out the causes of the disease and correctly prescribe medications. Particular attention should be paid to allergic manifestations in young children. Indeed, due to children’s physiology, pathological processes proceed rapidly, therefore, assistance must be provided promptly.

Usually, the mucous membrane of the eyes is able to recover from injuries or cracks on its own. However, this does not always happen. Sometimes, itching in the eyes indicates a corneal ulcer of an infectious or non-infectious nature. Such conditions can cause tissue necrosis with the appearance of irreversible processes. The development of a corneal ulcer can also cause dry eye syndrome.

Often, itching in the eyes accompanies the onset of meibomitis, as well as suppuration in the hair follicle of the eyelashes, called stye. The appearance of such a disease is associated with the penetration of a bacterial infection, which develops against a background of reduced immunity. Barley is usually accompanied by the appearance of redness and swelling, its center, when ripe, resembles a white grain, due to pus inside.

Inflammation of the ciliary margin of the eyelids is called blepharitis. This disease also causes unbearable itching in the eyes. It has several varieties: scaly, ulcerative, angular, meibomian, allergic. Therapy for blepharitis is always specific, associated with the cause that caused the inflammation process.

The cause of demodicosis of the eyelids and eyes is the demodex mite, which is normally a permanent inhabitant of our skin. The disease develops in case of violation of metabolic processes, reduced immunity or beriberi. At the same time, crusts appear in the eye area, the eyelids begin to itch, hyperemia of the eyes and eyelids develops. Occasionally, demodicosis of the eyelids is accompanied by itching of the head and dandruff. This is because demodex is able to activate on the entire surface that has a hairline. And, it is not worth being surprised that cosmetic shampoos cannot eliminate dandruff and itching of the head. You just need to use special medications.

Itching of the eyelids is also often caused by a disease of the conjunctiva – conjunctivitis. It can be caused by an allergy, viral or bacterial infection. Self-medication in such a situation is ineffective and even dangerous. With conjunctivitis, you should definitely seek medical help.
Dryness of the mucous membranes of the organ of vision, as a rule, is caused by beriberi, endocrine diseases, age-related changes, and prolonged visual work. Dry eyes are also accompanied by itching and discomfort.

Inflammation of the cornea of ​​an infectious or traumatic nature causes keratitis, which is manifested by itching, redness of the eyes, pain, clouding of the cornea, the appearance of ulcers. Viral and fungal keratitis are especially dangerous.

Treatment of eyelid itching

It should be clearly understood that the treatment of eye diseases is the work of an ophthalmologist. It is very difficult to independently establish the exact cause of the condition that has arisen, and sometimes it is completely impossible. Descriptions of the symptoms of diseases found on the Internet or medical reference books, as a rule, do not give anything. And the unreasonable use of drugs contributes to the distortion of the clinical picture and the transition of the disease to a chronic course, which only aggravates the general condition.

Approach to the choice of means of treatment of a particular eye disease should be professional. After all, the task of a therapeutic agent is to eliminate the cause of the symptom, and not its manifestations. Usually, for the treatment of infectious eye diseases, specialists prescribe antibacterial or antiviral agents. Eye ointments Zovirax (Acyclovir), Nucleavir do an excellent job with viral agents, in addition, eye drops Poludan, Aktipol, Okoferon help well. Bacterial eye infection is effectively eliminated with eye ointments and drops with antibacterial action, such as: Sulfacyl sodium, Norfloxacin, Tetracycline, Tobrex, Gentamicin, Floxal, Ciprofloxacin, Levomycetin, Oftamirin. There are effective remedies that reduce the manifestations of allergic reactions. These are antihistamines used orally: Ceterizine, Loratadine, Fexofenadine, Levocetirizine, as well as drugs used externally: eye drops Cromofarm, Cromohexal and corticosteroids Hydrocortisone, Prednisolone.

Demodicosis can be eliminated only by complex treatment, which includes vitamin therapy, topical preparations and immunity boosters, such as Stop Demodex eye cream and antihistamines.

To avoid diseases that cause itching of the eyes and eyelids, it is necessary to observe very simple rules of personal hygiene and to treat any chronic diseases responsibly. The use of vitamin-mineral complexes for the prevention, plus the organization of an optimal diet throughout the year, will help reduce the risk of eye pathologies.

In the Moscow Eye Clinic medical center, everyone can be examined using the most modern diagnostic equipment, and, based on the results, get advice from a highly qualified specialist. The clinic is open seven days a week and operates daily from 9 a.m. to 9 p.m. Our specialists will help identify the cause of vision loss and carry out competent treatment of the identified pathologies.

You can make an appointment at the “Moscow Eye Clinic” by phone in Moscow 8 (800) 777-38-81 8 (499) 322-36-36 (daily from 9:00 to 21:00) or by using the online booking form.

Blepharitis: symptoms, causes, diagnosis, treatment of eye blepharitis

Contents:

• Etiology
• Symptoms
• Clinical forms
• Diagnostics
• Treatment
• Therapy
• Complications
• Prophylaxis

Blepharitis is a large group of eye diseases that are accompanied by inflammation of the eyelid margins and cause discomfort in patients of all ages, ethnicity and gender. Blepharitis is one of the most frequent, having a chronic course, with frequent relapses and, as a rule, 2-sided eye damage. It occurs in adults and children. It is believed that blepharitis affects more than 24% of the total number of patients with inflammatory eye pathology seeking outpatient care. Women get sick more often than men. The incidence of blepharitis increases with age.

Etiology

Damage to the edges of the eyelids by microbes, viruses, fungi, mites, lice. A large group consists of allergic diseases of the eyelids. Often the development of blepharitis is associated with a violation of the tear coating of the cornea – a dry eye disease. It can also develop in violation of the general condition of the body and occurs with reduced nutrition, hypovitaminosis, metabolic disorders, diabetes, tuberculosis, diseases of the teeth, nose, tonsils, and chronic intoxication as a result of helminthic diseases. Very often, blepharitis occurs with uncorrected farsightedness glasses, with poor hygienic working and living conditions.

Symptoms

The most common symptoms of blepharitis are: redness and thickening of the edges of the eyelids, swelling, infiltration, skin of the eyelids covered with scales, loss of eyelashes (modarosis), abnormal growth (trichiasis), lacrimation, heaviness in the eyes, fatigue, dryness in eyes, discharge, increased sensitivity to smoke, wind, dust, bright light increases in the evening, burning sensation and itching of the eyelids.

Localization:

• Anterior marginal blepharitis (inflammation of the glands of Zeiss and Moll) affects the ciliary margin, there may be skin manifestations and bacterial keratitis.
• Posterior marginal blepharitis (meibomian glands) develops with hyperfunction, dysfunction or inflammation in the glands, there may be blepharoconjunctivitis and blepharokeratoconjunctivitis.
• Angular – inflammation develops in the corners of the eyes.

According to the nature of the flow, they are distinguished:

• Acute
• Subacute
• Chronic (uncorrected refractive errors, dry eye syndrome, chronic conjunctivitis, gastrointestinal tract diseases, endocrine diseases)

Clinical forms

Ulcerative blepharitis

Caused by a chronic, usually staphylococcal infection, there is a change in the hair follicles of the eyelashes leading to the destruction of the follicle and an ulcer. The edge of the eyelid is hyperemic, thickened, the eyelashes can stick together at the base, scars subsequently form in place of the sores. Eyelashes may fall out (modarosis), cicatricial changes can lead to deformation of the eyelids and abnormal growth of eyelashes (trichiasis). There may also be a lesion of the cornea – marginal bacterial keratitis.

Scaly (seborrheic) blepharitis

Develops in inflammatory diseases associated with eyelash follicles and Zeiss and Moll glands. Often combined with seborrheic dermatitis of the scalp, eyebrows, body parts. It flows more easily than ulcerative. Eyelashes and edges of the eyelids are powdered with pityriasis scales. Patients complain of burning, itching, heaviness of the eyelids, eye fatigue. The edges of the eyelids may be hyperemic, thickened. Often combined with chronic conjunctivitis, sometimes accompanied by marginal keratitis.

Meibomian blepharitis, or more commonly blepharoconjunctivitis

Develops with inflammation and hypersecretion of the meibomian glands. The edge of the eyelid is thickened, hyperemic, the excretory ducts of the meibomian glands are visible, filled with a yellowish-gray discharge. When pressing on the cartilage of the eyelid, a cloudy pasty secret is squeezed out of the glands. Complaints of itching of the eyelids, frothy discharge in the corners of the eyes. When the glands become infected, edema, hyperemia of the skin and conjunctiva appear, and the discharge increases.

Demodectic blepharitis

Develops due to tick-borne lesions of the edges of the eyelids. Ticks Demodex folliculorum affect the ciliary follicles, can be saprophyte. Demodex brevis – Meibomian glands and glands of Zeiss. Ticks are found at the root of the removed eyelashes. In 80% of cases, asymptomatic carriage, 1-2 individuals (not treatable!) Diagnostic confirmation (laboratory study) is the detection of 4-6 ticks in combination with young forms – eggs, larvae, nymphs.

In the initial stage of the disease, patients complain of constant, sometimes unbearable itching, especially after sleep. During the day, the feeling of pain, sticky discharge, the desire to scratch, wipe the eyes worries.

In the future, a pronounced inflammation of the ciliary edge of the eyelids develops, which become thickened, reddened, meibomitis often develops. The secret of the sebaceous glands and scraps of cells form a “collar” at the base of the eyelashes. Dried discharge accumulates in the form of scales between the eyelashes, forming a yellowish crust. With a long course, it can be accompanied by more severe eye lesions: conjunctivitis, keratitis, corneal ulcer.

Allergic blepharitis

It develops as a reaction to an allergen (pollen, house dust, animal hair), pseudo-allergic as a toxic reaction to a drug (medicated blepharitis) and infectious-allergic blepharitis as a result of exposure to a bacterial or viral infection. Usually combined with inflammation of the mucosa (allergic blepharoconjunctivitis), occurs with increased sensitivity to drugs, cosmetics and perfumes, pollen, dust (home or industrial), cockroaches, wool, feathers, fluff, household chemicals, pesticides, detergents and more. The same can be observed with eyelash extensions.

Acute allergic blepharitis occurs suddenly: swelling of the eyelids, lacrimation, mucous discharge, pain in the eyes, itching of the eyelids, photophobia. Both eyes are usually affected. Chronic allergic blepharitis is especially characterized by severe, sometimes unbearable itching of the eyelids.

Seasonal exacerbations are characteristic of pollinous blepharitis caused by pollen during the flowering period of grasses, cereals, trees. Drug-induced blepharitis most often develops with long-term use of eye drops and ointments, but can also occur with oral medications.

Eyelid blepharitis with molluscum contagiosum

The virus belongs to the group of poxviruses, pathogenic only for humans, transmitted by contact. The disease is characterized by rashes on the skin of the face, neck, chest, upper and lower extremities, single or multiple nodules. On the skin of the eyelids, one or more nodules are formed, ranging in size from a pinhead to a pea, spherical in shape, smooth, dense, painless, normal skin color, less often with a slight pearly sheen. An indentation appears in the center of the nodule. With the localization of nodules on the eyelids, viral particles can enter the conjunctiva. The secondary immune response leads to the development of secondary blepharitis and follicular conjunctivitis. The follicles are large, mainly on the lower eyelid. Sometimes there is keratitis.

Blepharitis in systemic allergies

In atopic dermatitis, it occurs in almost all patients and is severe with frequent relapses. Often combined with conjunctivitis and keratitis. The anamnesis is characterized by hereditary predisposition to allergic diseases. Eye damage is bilateral, chronic, slowly progressive. The most common complaints of patients on itching of the eyelids and periorbital skin.

Eyelid eczematous dermatitis is characterized by dry, inflamed skin with scales. Meibomian gland dysfunction, keratinization, and dry eye development often occur. The edges of the eyelids are usually infected with staphylococcus aureus, which leads to persistent blepharitis, dry eye syndrome develops. It is also possible to develop conjunctival edema with a papillary reaction mainly on the lower eyelids. Corneal lesions range from punctate erosions to neovascularization, stromal scarring, and ulceration. A tendency to develop a secondary infection is revealed – bacterial, fungal, herpetic.

Blepharitis leading to marginal keratitis or marginal corneal ulcer

Various chronic blepharitis with staphylococcal lesions of the eyelid margins and often the conjunctiva (chronic blepharoconjunctivitis) can lead to their development. Corneal damage is the result of a local staphylococcal hypersensitivity reaction.

Marginal keratitis appears as a yellowish-white infiltrate, usually solitary, near the corneal margin. The conjunctiva adjacent to the area of ​​keratitis is hyperemic, with numerous vessels.

Corneal ulcer appears as a limited superficial infiltrate stained with fluorescein. The conjunctiva is hyperemic, the discharge is insignificant. An ulcer can be long-term, recurrent.

Diagnosis

It is not difficult – this is an examination of the patient by an ophthalmologist on a slit lamp, assessment of the state of the tear film.

If demodicosis blepharitis is suspected, the patient’s eyelashes are taken from the upper and lower eyelids, with further laboratory testing for the presence of the pathogen.

To clarify the infectious nature, a bacterial culture of a smear from the conjunctiva is performed.

Treatment

The main treatment for all forms of blepharitis is the use of hygienic gels on the skin and the edges of the eyelids. The aim of the treatment is to free the meibomian glands from thick secretion and thereby eliminate the nutrient medium favorable for the growth and reproduction of microorganisms and mites.

Depending on the clinical course, drugs of other pharmacological groups are added (anti-infectious, anti-allergic, anti-inflammatory, drugs of complex forms and, of course, tear replacement therapy drugs), if necessary, eyelid massage is performed.

Eyelid hygiene

Gels – Teagel, Blefarogel 1 and Blefarogel 2, Blefaklin wipes, Blefarolotion. They help to clean the eyelids and eyelashes from mucus and scales, dissolve and remove serous mucus from the eyelids, refresh and soften the eyelids. A small amount of gel is applied to a cotton pad, stick or other, and the eyelids and eyelash roots are lubricated, the eyelids are wiped several times in a circular motion until the impurities are removed. Gel residues are removed with a clean disk. Application 1-2 times a day.

Also, to clean the excretory ducts, warm compresses are used in the form of a cotton pad soaked in warm water, which must be squeezed out and put on the eyelids for 5-10 minutes 2-3 times a day.

Antibacterial agents

Included in the complex treatment of blepharitis, since infection is proven or suspected in most cases. Antiseptics that have a wide spectrum of action and good tolerance (vitabakt, chino) or antibiotics with a pronounced bacterial infection are used (Vigamox, Floxal, Tobrex, Signeceph)

Anti -inflammatory drugs

9000 so: Dexamethason – Dexapos, Maxidex or non-steroidal anti-inflammatory drugs: Nevanak, Broxenac, Diclofenac and as an anti-inflammatory drug – Restasis.

Complex agents

Eye drops and ointments are used, including an antibiotic and dexamethasone: Dexagentamicin, Tobradex, Combinil – Duo.

Antiallergics

Used for severe eye irritation and eyelid edema: Opatanol, Alleogodil, Lecrolin, Oftalmoferon h, Systane balance, Thealoz, Cationorm (restoration of the lacrimal films)

It should be noted that in the first days of treatment, especially in acute cases, drugs are used more often, less often – in the second and third weeks. In the third week, drugs are usually partially replaced, somewhere from the fourth week, including tear replacement agents, and if further treatment is necessary, tear replacement therapy remains. The therapy algorithm is associated with the clinical forms of the disease.

In some cases of chronic blepharitis, treatment may be delayed for several months.

See also

3 diseases that can be treated with manual therapy

Herpes on the lip

Polycystic ovaries: symptoms, diagnosis and treatment

Magnetotherapy: indications for the procedure and benefits

Therapy

Algorithm for the treatment of ulcerative blepharitis

Basic: Teagel – thorough hygienic treatment of the skin and eyelid margins 2 times a day during the entire course of treatment. Ointments with antibiotics are also used: Kolbiotsin, Floksal, Futsitalmik. In severe cases of ulceration, Dex-gentamicin eye ointment is additionally applied to the edges of the eyelids 2 times a day until the condition improves.

Anti-infective: Vitabact 2-3 times a day for up to 2 weeks, in severe cases – Vigamox, Floxal, Tobrex, Signicef ​​first 3-4 times, and from the second or third week 2 times a day.

Anti-inflammatory: with prolonged irritation – Nevanak, Broxenac, Diclofenac or Oftalmoferon 2 times a day for 1-2 weeks.

Tear replacement: Hilo chest, Okutiarz, Systane balance, Thealoz, Cationorm (tear film restoration) 2-3 times a day up to 6-8 weeks.

Algorithm for the treatment of scaly (seborrheic) blepharitis

Basic: Teagel – thorough hygienic treatment of the skin and eyelid margins 2 times a day during the entire course of treatment.

Anti-infective: Vitabact 2-3 times a day for 2-3 weeks, with severe infection – Vigamox, Floxal, Tobrex, Signicef ​​3 times a day during the first week, the second – 2 times a day.

Anti-inflammatory: Nevanak or Broxenak 2 times a day for 1-2 weeks, with persistent recurrent course – Restasis 2 times a day for 3-6 months, until the condition improves.

Tear replacement: Hilo chest, Okutiarz, Systane balance, Thealoz, Cationorm (tear film restoration) 2-3 times a day up to 6-8 weeks.

Algorithm for the treatment of meibomian blepharitis

Basic: Teagel – hygienic treatment of the skin and eyelid margins 2 times a day, with severe meibomitis – massage of the eyelids with a glass rod. With relapses, the course of treatment is repeated.

Anti-infective: in case of proven or suspected infection – Vitabact 2-3 times a day for 2-4 weeks, in severe cases – eye ointment Dexa-Gentamicin on the edges of the eyelids 2 times a day.

Anti-inflammatory: Nevanac, Broxenac, Diclofenac 2 times a day for up to 2 weeks, in cases of persistent, recurrent course – Restasis 2 times a day, 3-6 months.

Tear replacement: VitA-Pos eye ointment or drops Hylo chest, Okutiarz, Systane balance, Tealoz, Cationorm (tear film restoration) 2 times a day for 3-6 weeks.

Algorithm for the treatment of demodectic blepharitis

Basic: Teagel – hygienic treatment of the skin and eyelid margins 2 times a day, if necessary – massage of the eyelids with a glass rod 1 time a day.

Anti-infective: Vitabact or Vigamox or Floxal or Tobrex 2-3 times a day, in severe cases – eye ointment Dexa-Gentamicin on the edges of the eyelids 2 times a day. In stubborn cases, a 1-2% gel or an extemporaneous 0.5% solution of metronidazole is used to treat the edges of the eyelids 2 times a day.
Blefarogel 2, Demazol, Demalan ointments, Glycodem gel for eyelids are also used.

Anti-inflammatory: in case of severe irritation – Dexapos 2 times a day.

Tear replacement: Hilo chest, Okutiarz, Systane balance, Thealoz, Cationorm (tear film restoration) 2 times a day for several weeks.

The goal of treatment is to reduce the number of mites. We focus on the clinic and the patient’s feelings. On average, the course of treatment is 30-45 days.

Algorithm for the treatment of allergic blepharitis

Basic: elimination of the culprit allergen. Hygienic treatment of the eyelids – Teagel followed by application to the skin and edges of the eyelids Hydrocortisone, Locoid 2 times a day in the form of gels and ointments, eye drops Opatanol, Lecrolin, Alomid, Allergodil 2 times a day until the allergic reaction subsides. If necessary, general antihistamines are used in the form of tablets and injections.

Anti-inflammatory therapy may be required as an adjunct to reduce irritation: Dexapos, Diclofenac, Restasis.

Tear replacement: Hylo dresser, hylan or artificial tear 2 times a day for a long time.

Algorithm for the treatment of blepharitis in case of damage to the eyelids by molluscum contagiosum

Basic: electrocoagulation of nodules or scraping them with a sharp spoon, followed by cauterization with iodine tincture.

In the event of blepharitis and conjunctivitis – treatment of the edges of the eyelids with Allergoferon eye gel 2 times a day and instillation of Ophthalmoferon eye drops.

In case of corneal damage additionally: Vitabact 2 times a day, Diclofenac 2 times a day.

Tear substitutes: Hilobak, Okutiarz, Gilan 2 times a day until the unpleasant subjective symptoms disappear.

The prognosis is favorable. During treatment, the wound dries up at the site of the nodules, the crusts fall off without leaving scars, and subsequently the phenomena of blepharitis, conjunctivitis and keratitis disappear.

Algorithm for the treatment of blepharitis in systemic allergies

Basic: Teagel – hygienic treatment of the skin and eyelid margins 2 times a day.

Anti-inflammatory: Opatanol, Ophthalmoferon, Dexapos, Diclofenac, restasis 2-3 times a day, in severe cases, additional subconjunctival injections of dexamethasone daily, 10 days.

Anti-infective: Vitabact, Tobrex, Vigamox, Floxal, Signicef ​​2-4 times a day depending on the severity of the course (antibiotics be careful – the risk of an allergic reaction).

Tear replacement therapy: Hilabak, Okutiarz, Gilan, VitA-Pos 2-3 times a day throughout the course of treatment, but longer use may be required in case of dry eye development.

Optional: Treatment prescribed by an allergist-dermatologist.

It should be noted that acute blepharitis can be cured quite quickly, while the treatment of chronic blepharitis presents great difficulties, especially in recurrent clinical forms. In each specific case, an individual choice of therapeutic regimen is required. Often repeated courses of treatment are required. Various drug combinations have been described using a wide variety of drugs.

Systemic therapy includes vitamin therapy, immunostimulating, autohemotherapy. The combination of local and general drug treatment in combination with physiotherapy (UHF, magnetotherapy, electrophoresis, darsonvalization, UV radiation), irradiation with Bucca rays is effective.

Complications

In some cases, the disease acquires a protracted, recurrent course, leading to the appearance of styes, chalazions, deformation of the eyelid margins, the development of trichiasis, chronic blepharoconjunctivitis, keratitis, tear film instability, deterioration of visual functions.

In complicated forms of blepharitis, surgical treatment may be required: removal of the chalazion, eyelid surgery for trichiasis, correction of inversion or eversion of the eyelid.

Prophylaxis

Prophylactic measures include adequate hygiene of the eyelid margins, enhancement of general immunity, prevention of infection of the anterior segment of the eye.

With timely and adequate treatment, the prognosis is favorable, and the occurrence of frequent relapses with the development of chronic blepharitis is not ruled out.

Literature

1. Maychuk Yu.F. Blepharitis. Modern drug therapy, a manual for physicians, second edition, supplemented. – M., 2013 – 25 from
2. Egorov E.A. Blepharitis // Ophthalmology. National leadership. Edited by S.E. Avetisova, E.A. Egorova, L.K. Moshetova, V.V. Neroeva, H.P. Takhchidi. – M. – 2008. – Section 5.4. – S. 342-347.
3. Safonova T.N., Kintyukhina N.P., Sidorov V.V. Treatment of chronic blepharitis.