Chronic Blepharoconjunctivitis (Eyelid Irritation)

 
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What is Chronic Blepharoconjunctivitis (Eyelid Irritation)?

Chronic blepharoconjunctivitis is a common eyelid disorder in persons over 40 years of age and it really represents at least four different types of chronic eyelid disorders for which the treatments are similar although not identical. It is one of the more difficult and frustrating disorders to treat because of its slow response to treatment.

Symptoms and signs

Usual clinical symptoms include burning, itching, scratchy feeling and mattering of the eyelids. Often the burning is more prominent in the morning and typically decreases throughout the day without disappearing. There is often a waxing and waning of symptoms and many persons have had symptoms for several years.

The eyelids are sometimes red (inflamed) and often crusted (especially in the mornings). The tears may be foamy and the eyelashes are usually covered with a greasy discharge (see illustration). Some of this material is easily removed with washing of the lids but in some persons the oil glands in the lid are plugged with a greasy flaky material which is impossible to express or remove. Up to 50 percent of the persons also have decreased ability to make tears and have symptoms of dry eyes including corneal discomfort. Some persons also have associated areas of skin irritation on the face and body.

Illustration of the eye

 

Treatment

The treatment is usually aimed at control of the process rather than a cure and most persons will require long-term therapy to control the symptoms.

  1. Initial therapy should include hot compresses once or twice daily. First, a face cloth is soaked in water as warm as the eyelids can stand, then it is applied to the lid surface for a one or two minute period. The purpose of the hot compress is to heat the debris and crust on the eyelid margins and to melt the greasy deposits.

  2. The warm compresses should be followed by eyelid scrubs with baby shampoo. It is recommended that the baby shampoo be applied undiluted (or diluted one to one with water) to the index finger and that the patient gently rub the closed eyelids with a horizontal left to right motion. Any remaining crust on the eyelashes may be gently picked away using the fingernail. The excess shampoo should be rinsed away by splashing warm water on the gently closed eye. Then repeat this procedure on the other eye. The purpose of this scrub is to remove the debris from the anterior portion of the eyelid and lashes.

The above treatment is recommended until one is free of inflammatory signs. Once the symtoms disappear, therapy can be tapered to a once a day lid soak and scrub, preferably in the morning.

If the above therapy is not successful, consult this office for further instructions. You may need to apply an antibiotic ointment to the eyelids nightly to help treat any persistent infection and to help soften and remove any mattery deposits on the lashes.

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