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  • Blepharitis - Causes, symptoms and treatment. MF.

    Blepharitis is more often a chronic bilateral inflammation of the eyelids of infectious or inflammatory origin.

    Causes of blepharitis

    There are many causes of the disease. They are divided into local and general.

    To the local can include chronic eye diseases( conjunctivitis, keratitis), dysfunction of meibomian glands. One of the significant reasons is demodecosis of the eyelids, caused by the tick of the genus Demodex. In all the cases listed above, an infectious agent( viral, bacterial, fungal or arthropods) is almost always present.

    With allergic blepharitis, there is a corresponding inflammation. Uncorrected ametropia( visual impairment) often does not cause, but maintain the course of the disease due to degenerative changes in the eye.

    The general causes of blepharitis are much greater. This and worm infestations, and metabolic disorders( diabetes, beriberi), gastrointestinal tract( gastritis, colitis, pancreatitis, liver cirrhosis), immunodeficiencies( these include conditions after surgery and after long-term treatment with many drugs), variousSkin diseases( acne, seborrhea, psoriasis, eczema), ENT organs( chronic rhinitis, sinusitis) and teeth. With these conditions, there is a foci of infection that can spread with blood and eye currents, or a decrease in immunity and attachment of the pathogen.

    Blepharitis in elderly people is especially frequent due to changes in the body leading to atrophy of the epithelium and, as a consequence, to a decrease in local immunity.

    Symptoms of blepharitis

    There are several types of inflammation of the eyelids: scaly, ulcerative, meibomia, demodectic blepharitis.

    With scaly( seborrheic) the epithelium slides and the picture resembles dandruff, only localized on the eyelids.

    Scaly blepharitis

    With ulcerous( staphylococcal), crusts are formed, combing which causes ulcers that can heal by scarring, which leads to eyelid deformation and improper growth of eyelashes.

    Ulcerative blepharitis

    With meibomia, the outflow of secretion from the glands is broken, the eyelids are hyperemic. In the intramarginal margin, the mouth of the enlarged glands is visible.

    Mabemia blepharitis

    Demodectic blepharitis is characterized by the appearance of scales, a thickening of the edge of the eyelid and the formation of white muffs on the eyelashes.

    Demodectic blepharitis

    Depending on the localization of the process, anterior, posterior and angular( angular) blepharitis are isolated. The anterior one is often associated with concomitant skin diseases( seborrhea, eczema, acne) and is localized on the ciliary edge of the eyelid. The posterior arises from the dysfunction of meibomian glands in the thickness of the eyelid and often leads to complications. When angular inflammation is localized in the corners of the eye.

    Symptoms on which eyelid inflammation can be suspected:

    - itching or burning;
    - redness;
    - lacrimation;
    - formation of scales, they can be bleeding if they are combed;
    - fragility and loss of eyelashes;
    - accumulation of secretions in the corners of the eyes;
    - fast visual fatigue.

    If any of the above symptoms occur, you should immediately contact the oculist at your place of residence or in a private clinic. Self-medication can be not only ineffective, but also harmful to health.

    Diagnosis of blepharitis

    For a specialist, diagnosis is not difficult. This requires only a medical history and simple diagnostic manipulations, such as external examination and biomicroscopy( examination with a microscope).

    And to find out the causes of the disease and the appointment of treatment will require additional methods of research, such as checking the visual acuity, t.abnormalities of refraction can complicate and support the course of the disease, examination of the fundus to exclude concomitant diseases, possibly scraping flakes from the affected areas with their further microscopy and possible detection of the pathogen. Consultation of related specialists( ENT, dentist, dermatologist, endocrinologist, etc.) is necessary to exclude foci of infection( if necessary, they must be sanitized), immunodeficiency and metabolic disorders that may cause blepharitis.

    In the diagnosis of demodicosis, eyelash microscopy is important. Normal is considered to be no more than 2 ticks in the entire preparation( 4 eyelashes from each century - a total of 16).

    Laboratory diagnostics includes general clinical tests, including a blood test for sugar, detection of the causative agent of bacterial, viral or parasitic blepharitis by seeding on nutrient media, immunoenzymaticanalysis, etc.

    Treatment of blepharitis

    Treatment should be comprehensive and preferably etiologically directed, i.e.it is necessary to eliminate the cause of the disease. Compulsory toilet is damaged every day 2-3 times.

    With , the simple blepharitis is removed by flapping with a cotton swab soaked in a furacilin solution, followed by careful treatment with an alcohol solution of brilliant green 1%.2-3 times a day, they put dexamethasone ointment on the eyelids.

    With ulcerative blepharitis e softens crusts with ointments( tetracycline 1%, erythromycin 1%) and treated with a solution of antiseptics. Hormonal ointments are contraindicated.

    With , the meibomian glandular dysfunction of is performed by treatment of the eyelids as described above and massage with a glass rod after dropping drops of anesthetics( Dicaine, Alkain).

    In all cases, it is necessary to instill solutions of antiseptics in the conjunctival sac( sodium sulfacyl sodium solution 20%, levomycetin 0.25% solution) to prevent the spread of the inflammatory process.

    Demodectic blepharitis requires long-term treatment( at least 1.5 months).The face is treated with tar soap. Damaged areas are treated with antiseptics.2-3 times a day, apply metrogil-gel. If there are allergy manifestations( itching, burning), use drops with dexamethasone( Maxidex, Oftan-dexamethasone).

    Physiotherapy methods help to speed up the healing process. When blepharitis is used:

    - electrophoresis with antibiotics and vitamins;
    - UHF therapy;
    - UFO-therapy;
    - magnetotherapy;

    Food should be high in protein, with the possible exception of allergens. It is not superfluous to receive multivitamin preparations. In some diseases, for example, diabetes, a strict diet is needed.

    It is possible to treat blepharitis with folk remedies, and some of them have a full right to exist. For example, wipe eyelids with a decoction of chamomile and calendula, strong green and black tea.

    Prevention of blepharitis

    Blepharitis is a chronic disease prone to relapse. Therefore, compliance with personal hygiene rules, eliminating the causes that caused inflammation, and strengthening immunity are the main methods of prevention.

    Complications of blepharitis

    Untimely treatment of a doctor can lead to serious complications, for example, keratitis, which will require inpatient treatment. It is also possible scarring and deformation of the eyelids, dysplasia of the eyelashes, the appearance of abscesses.

    Doctor ophthalmologist Letyuk T.Z.