Blepharitis/“Ocular Allergy”
(aka “Life in California”)
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Blepharitis is a chronic inflammatory condition of the eyelids. It may occur because of eye allergies, but often, there is no specific underlying cause. There is usually a buildup of oily secretions along the eyelid margin. Bacteria may grow at the base of the eyelashes causing discomfort when they produce a variety of toxins. Symptoms of blepharitis include crusting along the eyelid margin, redness of the eyelids or eyes and general irritation. Other symptoms may include stinging and a burning feeling in and around the eyes, itching (usually due to allergies) and sometimes the eyelids may stick together in the morning. Blurred vision may occur from oil in the tear film. Some patients experience headaches.
Blepharitis can begin early in childhood and continue throughout life as a chronic condition. Careful and consistent lid hygiene (lid scrubs) is necessary. The treatment should be ongoing (usually on a daily basis) and thought of like brushing teeth - it is helpful to prevent cavities even though there is not a guarantee against them.
The following treatment is suggested:
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Use cotton balls, make-up pads or a soft washcloth.
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Dilute baby shampoo in a small cup or small bottle of warm water.
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Wet the cotton ball.
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Close eyes and scrub along the lid margins (approximately 5-10 times across each eye). It should lather to clean best.
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Do this daily (twice as needed).
Artificial Tears
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Cool compress and artificial tears may also be recommended as treatment. Any over-the-counter artificial tears are fine, including the least expensive. I have found, however, that the store brands have a tendency to be more irritating and sting a bit. The bottle may say “artificial tears”, “lubricant eye drops”, “dry eye relief”, “moisture drops”, or even “natural tears”. Any of these are fine as long as it does not say “Allergy Drops” or “Gets the red out”. These latter drops sting and can cause a rebound effect which will cause you or your child to have to use the eye drops more frequently to control any redness.
Preservative-free eye drops may be recommended if the eyes are particularly dry or to further reduce irritation or corneal damage. These drops may also be used in contact lens wearers. Sometimes a gel or eye ointment will be added to your regimen to be used at bedtime (Refresh PM, GenTeal Gel, Systane PF).
Prescription allergy drops may be added if the above does not relieve symptoms or if there is significant itching of the eyes. Currently Zaditor ® (for children ≥ 6years) or Pataday are the best over-the-counter allergy drops.
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