It was a crisp morning when I bumped into Mrs. Sharma, a familiar face from the neighbourhood, at the local grocery store. She seemed unusually quiet, avoiding eye contact. When I asked if everything was alright, she hesitated before pulling me aside. “Dr. Priya,” she began her voice barely above a whisper, “my eyes have been so itchy and red. I wake up with them glued shut, and I’ve started losing my lashes. Could this be something serious?”

As a doctor, I immediately suspected blepharitis, a condition I’ve often encountered in my practice. Mrs. Sharma’s symptoms of persistent redness, irritation, and flaking around her eyelids were classic signs of this chronic eyelid inflammation. While it isn’t life-threatening, blepharitis can significantly affect one’s quality of life if left untreated.

What is Blepharitis?

Blepharitis is a long-term inflammation of the eyelid margins that can affect the eyelids, eyelashes, and even the whites of the eyes (conjunctiva). It can also impact the meibomian glands, which produce the oil essential for lubricating the eyes. Though it’s common, many people, like Mrs. Sharma, struggle with the condition because they don’t recognize the symptoms or seek help in time.

Recognizing the Symptoms

Over tea at my clinic later that week, Mrs. Sharma shared her struggles in detail. “It feels like there’s always something in my eye,” she explained, rubbing her lids. “And the flakes—it’s so embarrassing!”

Her description matched the hallmark symptoms of blepharitis:

• Persistent soreness or redness around the eyelids
• Greasy, scaly skin on the eyelid margins
• Small ulcers on the lids
• Sensitivity to light
• Crusting and occasional bleeding
• A sensation of grittiness or a foreign body in the eye
• Sticky discharge causing eyelashes to clump together during sleep

For Mrs. Sharma, the constant discomfort and self-consciousness about her appearance had started taking a toll on her daily life.

Understanding the Causes

Blepharitis can occur due to various reasons, and understanding the underlying cause is crucial for effective treatment. The condition is generally categorized into three main types:

1. Seborrhoeic Blepharitis: Linked to seborrhoeic dermatitis, this type involves greasy, scaly skin affecting the eyelid margins.
2. Rosacea Blepharitis: Associated with rosacea, a chronic skin condition causing facial redness.
3. Staphylococcal Blepharitis: Caused by a bacterial infection, often leading to more pronounced inflammation.

For Mrs. Sharma, her flaky scalp and history of rosacea suggested a combination of seborrhoeic and rosacea blepharitis.

Potential Complications

If left untreated, blepharitis can lead to complications that further affect one’s vision and eye health. I explained to Mrs. Sharma that the condition could cause:

• Styes: Painful infections at the base of the eyelashes.
• Meibomian Cyst Infection: Blocked and inflamed oil glands.
• Conjunctivitis: Inflammation of the whites of the eyes.
• Ulceration: Damage to the cornea, which can impair vision.
• Eyelash Loss: Permanent thinning or loss of lashes.
• Eyelid Scarring: Chronic inflammation can damage the eyelid structure.

Mrs. Sharma was visibly alarmed but relieved to know these complications could be avoided with proper care.

Treatment: A Step-by-Step Approach

Managing blepharitis requires a combination of good eyelid hygiene, lifestyle changes, and medical intervention. I assured Mrs. Sharma that while it might take time, her symptoms could be controlled with consistent effort.

Eyelid Hygiene

I explained that the cornerstone of treatment is keeping the eyelids clean. “Think of it like brushing your teeth,” I said. “It’s all about regular maintenance.” Here’s what I recommended:

• Warm Compresses: Apply a warm cloth to the eyelids for 10–20 minutes to loosen crusts and debris.
• Gentle Cleaning: Use a cotton bud dipped in warm water or a diluted baby shampoo solution to clean the eyelid margins.
• Frequency: Repeat this process once or twice daily, depending on the severity.

Avoiding Irritants

• Skip eye makeup during flare-ups.
• Avoid wearing contact lenses until symptoms improve.

Managing Seborrhoea

For her flaky scalp, I suggested using anti-dandruff shampoos and washing her hair regularly to minimize the risk of flare-ups.

Medical Treatment

In more severe cases, medications can provide relief:

• Antibiotic Ointments: These can target bacterial infections.
• Cortisone Ointments: Short-term use can reduce inflammation.
• Oral Antibiotics: If there’s a lid abscess or associated rosacea, oral antibiotics may be necessary.

The Path to Recovery

I reassured Mrs. Sharma that while blepharitis can be stubborn, consistent care usually yields results. “It might take six months or more, but with patience, you’ll see improvement,” I promised.

She left my clinic with a treatment plan and a newfound sense of hope. A month later, she reported feeling much better—her eyelids were less red, and the itching had subsided. Small victories like these are what make the journey worthwhile.