Blepharitis Treatment

 MGD and Blepharitis Treatment Options

I’m sure you would agree that constantly feeling like you have sand in your eyes, making them feel dry and scratchy would be debilitating. Did you know that dry eye syndrome and blepharitis sufferers feel this every day.

Depending on the cause of the dry eye, traditional treatments such as over the counter eye drops might not be dealing with the root problem. There is a mistaken assumption that the problem is a lack of tears. This is not the case in 85% of dry eye sufferers.

Enter Lipiflow. In this post you will discover the numerous chronic blepharitis treatments available. We will also understand how lipiflow is a new treatment for blepharitis that deals with the root cause of dye eyes, not just the symptoms. In order to understand this we need to first understand what blepharitis is.

What is Blepharitis?

Blepharitis refers to the inflammation of the eyelid. The lids become red and irritated with dandruff like scales forming on the eyelashes. Blepharitis is divided into 2 categories based on where on the lid the inflammation occurs.

  • Front or anterior part of the lid
  • Back or posterior part of the lid.

Front or Anterior Part of the Lid

Blepharitis is often caused by infection of the lid margin and leads to deposits on the eyelashes and a swollen eyelid. Bacteria secrete irritating substances which get into the eye, resulting in discomfort. There is also a skin condition called Seborrheic Blepharitis which is a form of eczema.

The main course of treatment for this condition is lid hygiene. The lid should be cleaned with commercially available lid wipes, such as Occusoft Plus. Occasionally, there is a need for use of topical antibiotics to treat associated infection.

Back or Posterior Part of the Lid

This form of Blepharitis is caused by a condition called MGD. MGD is by far the main cause of blepharitis.

MGD – The Main Cause of Blepharitis

Our eyelids contain tiny glands called Meibomian glands. These glands produce oils that form the top layer of the tear film. These oils prevent the water in your tears from drying out making them essential for eye comfort.

When the meibomian glands become blocked progressively less oil reaches the eye surface, leading to dry and exposed eyes often causing dry eye symptoms. This condition is called Meibomian Gland Dysfunction (MGD). MGD may cause dry eye syndrome (or dry eye disease) and may lead to an inflammation of the eyelids called blepharitis.

MGD and Blepharitis – Chronic Conditions

Blepharitis Treatment

It is important to first of all realise that Blepharitis & MGD (Meibomian Gland Dysfunction) are both chronic and progressive conditions. This means that they are not readily cured. They can however be contained with the help of a variety of therapies, resulting in a reduction of the severity their symptoms. If no action is taken however, these conditions are likely to get progressively worse, therefore the earlier the problem is dealt with, the greater the likelihood of success.

Since anterior and posterior blepharitis and MGD may be caused by many factors, before deciding on a particular treatment it is advisable to have an assessment by a specialist to ascertain the exact cause of your symptoms, in order to choose the therapy which is most likely to benefit you. If you are based in the UK you may want to visit our London or Manchester dry eye clinics.

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Treatment Options

Blepharitis TreatmentMild Blepharitis

For cases of mild Blepharitis, the first step in treatment is usually over-the-counter substitute tears in the form of drops, gels and ointments. There is a vast array of brands and formulations available, so it can be confusing deciding which to choose.

  • Eye Drops or Artificial tear drops provide quick relief with minimal blurring of vision but the short-lived effects mean they need to be used frequently to get adequate relief. Gel-like drops which cling to the surface of your eyes last longer than eye drops and need fewer applications, however, they can cause transient blurring of your vision. Unfortunately this only treats a symptom of the disease but not the disease itself, leaving the underlying problem to develop and sometimes worsen.
  • Ointments for Blepharitis, coat the front surface of the eye thereby reducing evaporation of tears, however, they are best only to be used at night as they can cause prolonged blurring of your vision.
  • If your condition is more than just occasional and mild, it is possible that you may need some sort prescription medication. Their purpose is to treat any bacterial overload which may be contributing to your condition, to reduce inflammation and to help your body produce better quality tears.
  • Another option is punctal plugs which are small sterile devices that are inserted into the small openings in the lids at the corner of your eyes. Their function is to block the drainage of the tears. This means the tear film stays longer on the eye hopefully resulting in fewer symptoms.

All of these options have some benefit, but if your dry eye is severe they will have limited success as they most likely will not treat the root of the problem.

Treatment Options for MGD

For the vast majority of dry eye sufferers, the cause of their problem is related to Meibomian Gland Dysfunction. This means the problem is not the production of tears, but the production of the outer oily layer of the tears. This makes eye drops completely ineffective. This problem needs a two-pronged attack to treat it:

  1. Heat melts the solidified blockages in the gland.
  2. Pressure expels the melted secretions.

Applying warm compresses to the closed eyes is a simple home remedy, in the form of warm flannels or more specialised ‘eye bags’ which can be heated in a microwave. Although they can provide some relief, their effectiveness is limited as most of the heat applied is carried away by the blood vessels. Also, the heat cannot penetrate the thickness of the eyelid to work effectively enough to fully resolve the problem.

The glands can be cleared by Meibomian gland expression, which can be carried out by optometrists and ophthalmologists. A forceps type device is used to squeeze the clogged contents out of the Meibomian gland. This can be effective but it can be very uncomfortable especially to those with low pain thresholds, and it does require excellent patient co-operation.

A More Effective Therapy

For those of you with moderate to severe MSG or blepharitis, you may want to consider cutting edge therapies designed to treat the root of the problem, that will potentially give you long term effective relief. IPL (Intense Pulsed Light),used in the cosmetic industry, was developed to treat abnormal blood vessels in the eyelid. This can lead to a reduction in inflammation which might be the cause of the malfunctioning of the glands leading to the blockage. This treatment is best used in conjunction with Meibomian Gland Expression and cannot be used on darker skin types. It needs to be repeated 3-4 times a month  This therapy can feel slightly uncomfortable  and may cause blistering and cheek swelling. Most symptoms have been reported to disappear within a week.

Blepharitis Treatment

Relieve Blepharitis Using Lipiflow Technology

Blepharitis Treatment

At our Dry Eyes Clinic based in Manchester, we use the most modern technology for the treatment of Blepharitis and have been getting very good results. Modern eye infection treatment gives us the ability to open the glands and re-establish a more normal oil output and improvement of the symptoms and alleviate MGD. This requires a professional assessment of the oil layer thickness and specialised photographs of the glands (called Meibography). This would then be followed by a painless expression of the glands themselves. We make use of a revolutionary technology called the ‘Lipiflow Technology’; this technology is backed by over 25 years of scientific research. With this new technology:

  • 79% patients reported improvement of their overall Blepharitis symptoms within four weeks.
  • Amazing new treatment that treats the root cause of Blepharitis, instead of just the symptoms.
  • The treatment is performed in a Consultation Room — and in some cases, on the same day as your evaluation.

Lipiflow is a Blepharitis treatment and is a very significant technological advanced way of managing evaporative dry eye. With a single procedure, applying a combination of directed heat and pulsatile pressure, many find a single treatment effective in relieving the blockage of their Meibomian glands. The LipiFlow is intended for the application of localized heat and pressure therapy in adult patients with Meibomian Gland Disease (MSG) and Blepharitis. Opening the blocked glands may allow your body to resume its natural production of tear film oil. Just imagine returning to doing the things you enjoy, without worrying about your eyes. We can help you take your first step to Blepharitis relief.

Some treatments could take time and they can be temporary but Lipiflow treatment is very fast and effective. The reason why you have been unable to receive long-lasting relief from the above mentioned ways is because the prescription remedies you’ve tried haven’t been targeting the primary cause of your condition – the blockage of your Meibomian glands located in your eyelids. LipiFlow technology is very effective for those who suffer from Evaporative Dry Eye. Our Practitioner will perform a series of evaluations to determine the reason why you have Blepharitis. You’ll start by completing a lifestyle questionnaire, a brief assessment to determine how your eyes feel on a daily basis.

In the cases of severe symptoms, LipiView Ocular Surface Interferometer will be used to carry out the first test. Lipiview is similar to you undergoing a thorough and complete eye examination. LipiView captures images of the tear film, processing 14 million pixels per second – more than a billion data points in total. This non-invasive process takes less than 5 minutes, and provides our Ophthalmologist with the information to further assess your tear film. With LipiFlow technology, heat is applied to the inner eyelid, mild sporadic pressure is also applied to release lipids from the Meibonian glands that were blocked. This process doesn’t damage delicate parts of the eyes or the glands. LipiFlow makes sure that the lower and the upper eyelids are treated concurrently.

Most, but not all, patients show improvement and even those not improving benefit greatly in preventing further withering of the meibomian glands and progression of the disease.

Blepharitis Treatment

How Does Lipiflow Treatment Work?

Blepharitis Treatment

How Is Lipiflow Technology Used?

Heat therapy can help to melt the contents of the gland to alleviate the blockage and allow a better flow of lipid to be produced. Many of you may have tried some of the heat therapies available for home use eg., hot flannels, eye bags, heated bean bags etc. These certainly can be of help, but there are some limitations to their effectiveness. Firstly, they do not maintain their temperature and cool down too
quickly to have any sustained effect. Secondly, the heat can only be applied to the outer eyelid and therefore isn’t targeting the correct area where the glands lie. In addition, the eyelid tissue itself, has insulating properties further reducing the effect of the treatment. Now fortunately, with the development of Lipiflow these problems have been addressed. The system applies constant, controlled, directional heat to the inner surface of the eyelid while protecting the rest of the eye with an insulated shield, thus providing precise, thermally controlled, safe heat to the targeted area. This, in addition to the application of pressure, facilitates the release of secretion from the obstructed gland helping to improve the lipid layer and relieve the symptoms of Blepharitis.

There is an eyepiece called the LipiFlow Activator that will be placed underneath the upper and lower eyelid, the eyepiece will be shaped in a way that contact with the cornea is prevented. When this is done, all you need to do is lie down on the treatment chair for the treatment procedure which could take roughly 12 minutes. In a clinical study, 32% of patients reported no discomfort and 48% of patients noted awareness of pressure without pain during the LipiFlow treatment.

This procedure, as mentioned earlier, would be performed in our Consulting Room, it is virtually painless and some patients consider it somewhat like a spa experience.

Blepharitis Treatment

“My life was taken over by Blepharitis syndrome… the most painful experience I have ever had! Now my eyes have improved weekly, the feeling of moisture again is wonderful. The treatment and support I received was fantastic. I have got my life back.”

Judith Lockhart

Blepharitis Treatment

Don’t ignore your Blepharitis and don’t wait for it to become chronic
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Give us a call on 033 33 444 977 to find out more