Blepharitis is a term denoting inflammation of the eyelids. It includes styes and even allergic reactions of the lids. The most common use of the term, however, refers to a condition involving the oil glands of the lid margin (about 20-25 openings in each lid) that produce the outer layer of tears. This oily layer serves to retard evaporation of the tears, thus conserving them. When inflammation affects these oilproducing glands, there is increased aporative loss of tears. Studies have shown that up to two-thirds of patients with Sjögren’s dry eye have this form of blepharitis. This condition is called posterior blepharitis or meibomian gland dysfunction and is the most common form of dry eye disease.
The most common form of treatment is the use of moist heat to the lids, cleansing of the lid margins and the use of oral antibiotics such as tetracycline. This regimen can result in significant improvement of the symptoms of irritation and pain. In more severe cases the use of locally applied steroids can be helpful. Current research is studying the use of locally applied hormone preparations and newer antibiotics to reduce inflammation and normalize the oil secretion.
By Michael A. Lemp, MD