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BLEPHARITIS.pptx inflammation of glands and lash follicles on the eyelid margins

blepharitis is swelling or inflammation of glands and lash follicle on the eyelid margins, usually where the eyelash hair follicles are located by the location of the problem, blepharitis can be anterior versus posterior

Education◦
BLEPHARITIS PROF.MRS REGI PHILIP MOUNT ZION COLLEGE OF NURSING ADOOR
INTRODUCTION • Blepharitis (blef-uh-RYE-tis) is a condition that causes swelling, itching and other irritation of the eyelids. Blepharitis usually affects both eyes along the edges of the eyelids. Blepharitis may be caused by usually harmless bacteria on eyelids that become overpopulated. • Blepharitis is a common and chronic inflammatory condition affecting the eyelids, particularly at the base of the eyelashes. While not serious, it can be uncomfortable and is often associated with dry eye syndrome.
KEY WORDS • Chronic inflammation of the eyelid margins causing irritation and redness • Two main types: anterior (front of eyelid) and posterior (meibomian gland dysfunction) • Not contagious and doesn't cause permanent vision damage • Cannot be cured but can be effectively managed with consistent lid hygiene • Often coexists with dry eye and may worsen dry eye symptoms
Difference between healthy eyelid and eye with Blepharitis
Eyelids belong to the so-called auxiliary organs of the eye, which do not participate in the process of vision, but with their function protect the eyeball and participate in the process of tearing. The anatomy of the eyelids is extremely complex. They consist of five layers that make up the skin and loose connective tissue, muscles, septum, tarsal plate and eyelids. The sebaceous glands (Meibom’s glands), whose outlets are located at the edges of the eyelids, also play an extremely important role, and their function is to create small amounts of fat that is part of the tear.
TYPES OF BLEPHARITIS
Types of Blepharitis • Anterior Blepharitis • Affects the outside front of the eyelid where eyelashes attach: • Staphylococcal blepharitis: Caused by Staphylococcus bacteria • Crusty, scaly debris at lash bases .May cause lash loss or misdirected lashes • Seborrheic blepharitis: • Associated with seborrheic dermatitis • Greasy, waxy scales on lid margins • Often affects eyebrows and scalp too
Types of Blepharitis • Posterior Blepharitis • Affects the inner eyelid (meibomian gland dysfunction/MGD): • Meibomian glands produce abnormal or insufficient oils • Leads to tear film instability • Strong association with dry eye syndrome • May be associated with rosacea • Mixed Blepharitis • Combination of anterior and posterior types • Very common in practice
Types of Blepharitis • Ulcerative Blepharitis (Severe Type) • This is a more serious and painful form. • Causes sores (ulcers) on the eyelid edges • May bleed and form crusts • Demodex Blepharitis (Mite-Related) • This type is caused by tiny mites (Demodex) living in hair follicles. • These mites feed on oil while you sleep • Can block follicles and cause itching and irritation
General causes of blepharitis 1. Bacterial Infection: One of the primary causes of blepharitis is bacterial buildup. It is often from Staphylococcus bacteria. This type of infection causes irritation and swelling along the eyelid edges. When bacteria accumulate, they can block oil glands, leading to the typical blepharitis symptoms like redness and itchiness. 2. Dandruff: Sometimes, blepharitis is linked to dandruff on the scalp or eyebrows, especially if it falls around the eyes. This can clog glands, causing irritation or a gritty feeling. Keeping hair and eyebrows clean may help in managing this cause. 3. Skin Conditions: Certain skin conditions, like rosacea or eczema, increase the risk of developing blepharitis. These conditions make the skin sensitive and can lead to chronic eyelid inflammation. People with oily skin may also experience more frequent issues with blepharitis. 4. Allergies: Allergies to cosmetics or contact lenses can irritate the eyelids and contribute to blepharitis. Avoiding allergens and using hypoallergenic products can reduce the chance of irritation.
CAUSES OFANTERIOR BLEPHARITIS • Acne rosacea: Rosacea causes facial skin inflammation, which can include your eyelids. • Allergies: Allergies to contact lens solution, eye drops or makeup can spur irritation. • Dandruff (seborrheic dermatitis): Dandruff flaking can irritate eyelids and cause inflammation. • Dry eyes: Dry tear ducts can alter bacterial resistance, resulting in infection. • Lice or mites in eyelashes (demodicosis): Lice or Demodex mites can block eyelash follicles and glands in your eye
Causes of posterior blepharitis • Meibomian gland dysfunction (MGD): When the oil from meibomian glands doesn’t flow freely, you can develop dry eye, which can result in inflammation and infection. • Acne rosacea. • Dandruff.
Causes of staphylococcal blepharitis • Staphylococcal Blepharitis • This is caused by a bacterial infection (Staphylococcus). • Can damage eyelids over time • May cause eyelash loss or lashes growing in the wrong direction
Causes of seborrheic blepharitis • Seborrheic Blepharitis (Dandruff- Related) • This is linked to dandruff on the scalp or eyebrows. • Causes greasy, soft flakes on the eyelids • Usually less painful but uncomfortable
Causes of Ulcerative Blepharitis • Ulcerative Blepharitis (Severe Type) • This is a more serious and painful form. • Causes sores (ulcers) on the eyelid edges • May bleed and form crusts
Causes of Demodex Blepharitis (Mite-Related) • Demodex Blepharitis (Mite- Related) • This type is caused by tiny mites (Demodex) living in hair follicles. • These mites feed on oil while you sleep • Can block follicles and cause itching and irritation
Stages of blepharitis • Stage 1: Early biofilm formation with swelling of the lash follicles, lash misdirection. • Stage 2: Inflammation of meibomian glands with plugging. • Stage 3: Lacrimal involvement leads to aqueous insufficiency with little to no tear lake. • Stage 4: Chronic inflammation leads to a breakdown in the structural .
Pathophysiology Provoke immune response against staphylococci Bacterial colonisation on eyelids clinical features of itching, burning and crusting of eyelid Many factors may lead to the instability of the lower eye lid Combination of low grade bacterial infections of ocular surface, inflammatory skin conditions such as atopy and seborrhea and parasitic infections with demodex mites Leads to direct invasion of eye lid
Symptoms of Blepharitis
Common Symptoms of Blepharitis • Eye irritation and eyelid inflammation can cause persistent discomfort throughout the day. Recognizing the common symptoms early can help in seeking timely care. • Lids burn, itch, or feel gritty all day long. • Crusts stick to lashes, gluing eyes shut in the mornings. • Red, swollen eyelid margins worsen with frequent rubbing. • Watery eyes or a dry sensation alternate confusingly. • Lash loss or white collarettes appear around lash bases. • Light sensitivity forces shade seeking even indoors.
Diagnostic examination • External examination • Skin or Eyelash Sample • In some cases, the doctor may gently collect a small sample from your eyelid or eyelashes. This sample can be tested to check for bacteria, fungi, or mites contributing to the symptoms • Patients history and physical examination • Check for facial and scalp skin for itching, facial flushing ,swollen blood vessels on cheeks and nose or swollen nose • Examination of tear film especially along the lid margins Tear film instability is usually evaluated by a simple tear break-up time (BUT) test using a vital dye, fluorescein. • Lash Epilation and Microscopy • If mite infestation is suspected, the doctor may remove a few eyelashes and examine them under a microscope. This procedure, known as lash epilation microscopy, helps detect the presence of Demodex mites
Diagnosis Process for Blepharitis • Slit Lamp Examination • A Slit Lamp Examination is one of the most vital instruments employed in the diagnostic process. It is a special microscope that enlarges the eyelids, lashes, and the surface of the eye. Using this equipment, physicians can clearly see crusting on the lash line, cylindrical dandruff-like collarettes, redness of the eyelid margin, and abnormalities of the openings of the meibomian glands.
Medical Treatment • Warm compresses • Wet a clean washcloth with warm water and wring it out until somewhat dry. Place the washcloth over your closed eyes for at least 1 minute. Wet the washcloth as often as needed so it stays warm. This will help loosen the flakes sticking around your eyelashes. It also helps keep nearby oil glands from clogging. • Eye drops • Artificial tears or steroid eye drops may reduce redness, swelling and dry eye. Your ophthalmologist might prescribe an antibiotic eye drop mixed with a steroid to help the oil glands work better.
Medical Treatment • Skin and eyelid hygiene • It is very important to keep your eyelids, skin and hair clean. This keeps your blepharitis symptoms under control. Carefully wash your eyelashes every day. Soak a washcloth, cotton swab (Q-tip), or lint-free pad in baby shampoo diluted in warm water. Then use it to gently scrub the base of your eyelashes. • Omega-3s (fish oil) • Omega-3 fatty acids, which may help the oil glands in the eyelids work better. Fatty fish like salmon or sardines contain omega-3s but you can also buy fish oil pills at the drug store. Ask your doctor if they might help you.
TREATMENT • Topical antibiotics are used to treat blepharitis of the outer eyelid (anterior blepharitis). They reduce symptoms and get rid of bacteria in the area. • Oral antibiotics are used to treat blepharitis of the inner eyelid (posterior blepharitis) caused by dysfunction of the eye’s oil glands (meibomian glands). They are also used for blepharitis associated with ocular rosacea. • Oral antibiotics for blepharitis • Two primary classes of oral antibiotics are used in blepharitis treatment: tetracyclines and macrolides. • Tetracyclines include antibiotics tetracycline, doxycycline, and minocycline. • Macrolides include antibiotics erythromycin and azithromycin. • Tetracyclines are broad spectrum antibiotics used to treat rosacea and various other conditions. Side effects include gastrointestinal distress and photosensitivity , among others.
Medical Treatment • Ointment and other topical blepharitis antibiotics • Bacitracin: The ophthalmic form of this antibiotic is for eye use only. • Erythromycin: This is an antibiotic used for a wide range of bacterial infections. • Neomycin, polymyxin, and bacitracin: This is a combination product of three antibiotics used to treat infections of the eye and eyelid.
Nursing management • Disturbed visual perception related to inflammation ad evidenced by burning and reddened eye • Acute pain related to inflammation of eye as evidenced by burning ,itching and swollen eyelids • Impaired tissue integrity of eye related to eyelid inflammation as evidenced by itcing of eyelids • Knowledge deficit related to eye care as evidenced by frequent questioning about disease condition
Blepharitis Complications •Eyelash Abnormalities: Long-term inflammation can cause eyelashes to fall out (madarosis), •lose their color, or grow inward toward the eye (trichiasis). •Corneal Damage: Ingrown lashes or constant debris can scratch the cornea, potentially leading to corneal ulcers or keratitis. •Styes and Chalazia: Blocked oil glands and bacterial infections at the base of the eyelashes often lead to painful styes or •firm, swollen bumps known as chalazia. • Tear Film Issues & Dry Eyes: Debris and irregular oil production alter your tear film, which can trigger severe •dry eye syndrome or cause excessive, irritating tearing. •Chronic Conjunctivitis: The inflammation or infection can easily spread to the transparent membrane over • your eyeball, resulting in chronic pink eye. •Eyelid Misposition: Severe cases can cause the eyelid to turn inward (entropion) or outward (ectropion).
PATIENT EDUCATION • Key Steps for Daily Lid Hygiene • Warm Compress: Place a warm, damp washcloth or a microwaveable eye mask over closed eyes for 5 to 10 minutes. This melts solidified oils and softens crusts. • Massage & Scrub: Gently rub along the base of the eyelashes with clean fingers, or use a cotton swab dipped in diluted baby shampoo (a few drops per cup of warm water) or a commercial lid cleanser. • Rinse: Wipe away loosened debris with a clean, warm washcloth and pat dry.
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