Anterior blepharitis is where there is debris of dried skin and mucous around the lid margins and at the base of the lashes. It can make eyes feel itchy and irritated, they can also look red and inflamed.
Anterior blepharitis can be caused by bacteria and can be associated with a skin mite called Demodex. It can also be due to dry skin conditions such as dermatitis.
The key is to keep the lids clean and free of debris and, where possible, either treat or remove the underlying cause.
Our preferred treatment is to use Blephex in the clinic followed by eye lid cleaning on a regular basis at home. Blephex is a great gadget which has a rotating device which is soaked in an eyelid cleansing product which then firmly but gently removes the build up around the lashes. It does the job so much more effectively than what can be achieved at home. It’s not an unpleasant procedure and is not uncomfortable. It feels like an unusual tickling sensation along the lids but is never painful. Afterwards, eyes feel refreshed and “clean” similar to how you feel after a scale and polish at the dentist. And, like the dental analogy, it’s much easier to keep the eyelids clean once they have been thoroughly cleaned with the Blephex treatment. In severe cases, we have to repeat the treatment once or twice to get the desired result but on the whole one treatment is sufficient.
At the same time, we debride the dead skin from the surface of the meibomian glands, somewhat like having microdermabrasion done at the beauty therapists. This makes it easier for the meibomian glands to function and easier for expressing the glands.
Following the Blephex further treatments such as antibiotics or a Demodex eradication program may be prescribed depending on the underlying cause. We then recommend a maintenance of home eyelid cleansing and an annual Blephex treatment.
It is not unusual for anterior blepharitis to co-exist with other conditions such as meibomian gland dysfunction or aqueous deficient dry eye etc. Those conditions can be treated after, or concurrently with, the treatment of the anterior blepharitis.