Update: December 2018 The term “blepharitis” refers to any
inflammatory process, located on the skin of the eyelids. Despite their
special position, in their structure, they are very similar
обычную skin The most superficial layer is covered with epidermis –
small horny scales that are constantly exfoliated and
are updated. The dermis itself is slightly deeper.
meibomian glands (analogs of the sebaceous ducts) and hair
bags for eyelashes.
Such skin similarity is manifested not only in structure, but also in
diseases. ATеки, также как и дерма на теле, могут страдать от
allergies, bacteria, parasites and other harmful factors that violate
cell work. An additional danger is located
nearby organ of vision, which can also be damaged by these
agents. That is why blepharitis, its symptoms need
timely recognize and treat so that the quality of a person’s life
remained at a high level.
AT первую очередь следует отметить, что далеко не каждый человек
may get blepharitis in the eyes. Its development requires the presence of
predisposing factors that will contribute to
diseases. These include:
- Reduced immunity. This condition may appear as
вследствие болезни (ATИЧ, диабет, онкологические процессы; в меньшей
degree in any chronic disease), and in ordinary
physical / mental overload. Stress, lack of sleep,
overwork – all this weakens our defense mechanisms;
- Burdened heredity. It is proved that every person
has a tendency to certain pathologies. No exception
and blepharitis century. Indirectly determine your predisposition can
Having analyzed the existing diseases of close relatives. If a
they were diagnosed with this, or there were any signs of inflammation
in the specified area (redness, discomfort, pain, etc.), then
genetics plays the role of a risk factor;
- The presence of allergies. For people who respond to action
certain substances (dust, wool, pollen, industrial
emissions, etc.) by inflammation, there is always a chance
damage to the eyelids, when allergen is exposed to them or the development of a common
- ATредные привычки: курение, злоупотребление алкоголем. These
substances not only negatively affect the immune function, but also
partially disturb the normal metabolism in the dermis.
If a у пациента имеется даже одно из вышеперечисленных условий,
the effects of blepharitis on it can lead to
Causes and types of blepharitis
ATыделяют пять видов этой diseases. Each form of blepharitis
corresponds to a specific reason that allows to suspect
correct diagnosis is still at the stage of clarifying the circumstances
возникновения первых symptoms.
Cause возникновения: Точно не
Механизм развития: AT настоящее время, считается, что
Cause: Гноеродные микробы –
Механизм развития: Попадание микроорганизмов в незаметные
Механизм развития: Этот процесс имеет циклический характер.
Механизм развития: Попадание паразита в дерму – еще не
Regional (WITHиноним – дисфункция мейбомиевых желез)
Cause: Нарушение работы желез,
The mechanism of development of blepharitis is not completely clear. Probably,
Symptoms and treatment of blepharitis of various origins significantly
different from each other so it’s very important
diagnose the form of the disease and carry out therapy already in
according to the identified cause.
Almost always, this pathology appears simultaneously on
two eyes and develops very slowly (over several
months or even years). To the most typical complaints with seborrheic
- Itching in the eyelids or feeling of “sand in the eyes.” To the patient
I always want to rub the sore spot, despite the fact that
this does not bring substantial relief;
- The feeling of “heaviness of the eyelids.” This symptom is most pronounced
after sleep or prolonged occlusion;
- Increased flaking of the skin. Separated particles are very similar
dandruff – they are small, thick and dry to the touch,
white / gray color.
When viewed, in addition to an excessive amount of flakes,
note redness (usually not intense) and thickening
edges of the eyelids.
What treatment can be selected for this form of blepharitis? Because
all changes are local in nature then affect
the disease follows only on a specific site. To therapy was
effective, you need to do two things – reduce inflammation and
регулярно очищать epithelium. To this end, the doctor may
- Alkalescent solution for eyelid hygiene (sodium bicarbonate
2%, Sodium chloride 0.9%) – to wash the eyelids and not touch it
the visual apparatus, it is better to use a cotton / gauze ball.
Remove horny scales should be 4-6 times / day throughout
course of therapy or peeling;
- Local glucocorticosteroid (hydrocortisone ointment or its
analog) – due to the fact that the drug has a hormonal nature, it
has an optimal anti-inflammatory effect. AT кровь
the drug is practically not absorbed, therefore, adverse reactions
after its use are extremely rare;
- Zinc Sulphate 0.25% solution – used in the form of lotions, in
as a supplement to the standard scheme. Zinc improves metabolism in
skin and may somewhat slow down the formation of scales.
Almost always the seborrheic form occurs chronically, with
alternation of exacerbations and remissions. No specific reason
occurrence leads to difficulties with therapy and the impossibility
finally save the patient from the pathology. However correct
подобранная схема, в большинстве случаев, позволяет успешно
контролировать проявления diseases.
Microbial growth can significantly damage cells
epithelium. ATыделяемый бактериями гной «разъедает» нормальные ткани и
leads to the formation of small ulcers on the skin. As a rule, they
quickly covered with dense crusts, the separation of which may be
very painful. Under the action of discharge from the wounds often
eyelashes stick together, and if hair is damaged
follicles often marked by their increased fragility.
The clinical picture in these patients is complemented by all the signs.
local inflammation, such as:
- ATыраженное покраснение;
- Pain of medium or low intensity, which is well removed
НПATWITHами (Нимесулидом, Цитрамоном, Мелоксикамом и другими);
- Increasing the temperature of the skin area – the eyelid feels warmer
You can suspect this form for the above symptoms, and
to confirm the diagnosis and select the best means of
blepharitis need to perform bacteriological examination.
The principle of this technique is simple – a smear from the affected patient is taken from the patient.
skin, “sow” microorganisms with him and watch their growth. WITH
using this method, doctors accurately determine the type of bacteria.
To get rid of malicious germs and restore
the normal condition of the century is used complex therapy, including
- Softening and removing crusts. Although this
The procedure is quite simple, as a rule, the doctor himself produces it.
To the patient будет достаточно проблематично сделать это самостоятельно,
because of the need to perform precise manipulations on your own
century. How to remove crusts? To do this, first put
ointment, reducing their density (suitable vaseline).
After it is absorbed, pathological
- Antibiotic therapy. Used only after deletion
crusts to ensure maximum drug interaction and
microbes. Preparations in the form of ointments (Erythromycin, Tetracycline, etc.)
Apply a thin layer at least 3 times a day. When expressed
symptoms of inflammation, doctors recommend using
combined antibiotic + anti-inflammatory drugs
a remedy such as Dex-Gentamicin;
- ATосстановление обмена веществ в эпителии. WITH этой целью пациенту
назначают примочки с раствором Цинка WITHульфата (достаточно
Microbes are the most common. the cause of the development of blepharitis in
children. They respond well to treatment and rarely go into
This form is very characteristic alternation of exacerbations and
complete health conditions. Symptoms of the disease, contrary to
common misconception does not manifest itself at the first meeting
person with an allergen. Only this happens at this moment.
�”Identification” and “memorization”, as a potentially harmful substance.
After that, within 1.5-2 weeks, the production
inflammatory proteins (IgM antibodies). It is their interaction with
allergens leads to the appearance of all signs of pathology.
In addition to the typical signs of inflammation of the eyelid (redness,
peeling, itching) is very characteristic of allergic blepharitis
swelling of the skin. It increases in size, while probing can
feel the presence of fluid in the tissues, the eye involuntarily
closes. In severe edema, the epithelium is stretched and
Thinning, due to which the tissues become white.
You can suspect the cause of inflammation by routine blood tests
from the finger. Increased eosinophil count (above
0,4*109/л) и базофилов (выше 0,7*109/л),
ESR acceleration (more than 15 mm / hour) and normal neutrophil level
(до 6*109/л)– все эти изменения свидетельствуют об
allergic nature of the disease.
Identify the substance to which a person has an individual
intolerance, in two ways:
- Analyze the time of onset of symptoms and detect
contact with any factor (flowering, contact with dust or
- Conduct special hypersensitivity tests –
There are a large number of variants of this procedure, but the most
Scarificational is common. In the course of her skin
small scrapings are made and various allergens are dripped into these places.
In this empirical way, individual intolerance is revealed.
patient certain substances.
How to treat blepharitis of this form? First of all, it is necessary
eliminate or minimize contact with intolerable
substances. If there is a sensitivity to a particular type
cosmetics – it must be replaced when it occurs
contact with dust, pollen and other
environmental factors, we can recommend the constant wearing
eyewear and regular eyelid hygiene.
Drug therapy is needed for quick elimination.
symptoms. As a rule, the effect of its use develops in
within a few hours after applying / taking the drug. AT
depending on the patient’s condition, he is prescribed one or more
desensitizing drugs listed below:
- General antiallergy therapy in the form of
таблеток или инъекций – Лоратадин, Дезлоратадин, Клемастин,
- Means for local treatment in the form of ointments or cream
– Hydrocortisone, Lokoid, Akortin, Latikort.
Most often, these funds are enough to normalize
skin condition and reduce inflammation. Most suitable for
only a doctor can pick up a particular patient, so
his advice and the provision of qualified
Parasitic lesion of the dermis has its own characteristics, allowing
distinguish pathology from other forms. Besides the typical symptoms
blepharitis such as itching, redness and thickening of the eyelid margin,
Patients can detect the following specific signs:
- ATозникновение обострений при повышенных температурах и
thermal / mechanical effects on the affected area. For example,
during cosmetic procedures – peeling, hot wrapping,
warming, etc. AT этих условиях, клещу значительно комфортнее
grow and multiply, in particular, due to increased blood flow
(hence the nutrients for the parasite);
- The appearance of small whitish scales on the eyelashes (figurative
name – “coupling”). As a rule, they are located near the skin,
the very base of the hairs. By nature, they represent
- Tick-demodex often leads to the development of persistent chronic
blepharitis. With the help of properly prescribed treatment, in most
cases, it is possible to completely get rid of the signs of the disease.
However, it does not prevent re-infection.
- Conventional therapy does not affect the course of the disease.
You can confirm the presence of demodicosis using a simple analysis.
For his holding from the patient requires only a few eyelashes. Their
treated with a special solution (glycerol, gasoline or
similar) and then examined under a microscope. Detection
tick allows you to make a diagnosis with a dot and start a specific
treatment of blepharitis century.
There are different treatment regimens that can prescribe
the doctors. The most effective of them allows you to get rid of
signs of pathology in 4 days and includes only three drugs for
|Drug name||Operating principle||Release form|
|Benzyl benzoate||Potent anti-tick agent that acts
as a poison for the parasite, accumulating in its body.
|Uniderm||Renders anti-inflammatory effect, eliminates part
symptoms and reduces skin damage.
|Emolium||A positive effect on the metabolism in the dermis and restores
После первого курса необходимо подождать 14-16 дней и
pass it again, for the prevention of relapse. Should remember
that for some people, these drugs can be harmful (in
particular pregnant women, with allergic lesions, etc.). therefore
before using them is strongly recommended
consult with a qualified doctor.
Detect regional blepharitis is very easy, thanks to the characteristic
symptoms. Only dysfunction of the glands leads to the release of excess
the amount of sebaceous-like secret, gray-yellow in color with frothy
consistency. Often it accumulates in the corners of the eyes, but it can
be directly under the eyelid. To find it, enough
bend the skin or slightly press on it, in the direction from the bone to
For the diagnosis does not require additional
techniques – this symptom is enough. Presence of others
signs such as redness, discomfort or soreness,
will serve as an additional confirmation.
At the marginal lesion of the century prescribe symptomatic treatment,
aimed at removing inflammation and hygiene of the affected
plot. Recommended daily treatment with warm alkaline
solutions followed by anti-inflammatory ointment
(Akortina, Hydrocortisone, etc.). Average duration
treatment 1.5-2 weeks.
Very often, this process takes a chronic course, therefore
The course of therapy should be repeated if recurrences occur.
exacerbations, but only after consulting a dermatologist.
Most blepharitis have a constant flow and will
periodically remind the patient of their existence. Fully
only ulcerative and demodectic forms can be cured, but
there is always the risk of re-developing them. To prevent this
happened, should pay attention to your lifestyle and
state of immunity. To prevent recurrence of eyelids
The following activities are recommended:
- Rejection of bad habits. Both smoking and frequent
alcohol consumption affects the entire body. AT
particular, these substances damage the liver cells, which
neutralize various toxic substances, blood-forming organs and
skin ATсе это приводит к снижению защиты человека от вредных
- Treatment of chronic diseases. Any pathological process in
body (infectious or non-inflammatory) leads to stress
our adaptive abilities. Simply put, fabrics
constantly come in a kind of “stress” and “fatigue.”
therefore важно своевременно выявлять свои заболевания и адекватно их
- Daily face hygiene. Mechanically removing sebum and part
microbes, we maintain the dermis in good condition, and allow
she fully perform their functions;
- Lifestyle correction. Overweight, permanent stay in
one pose, regular stress, lack of proper rest –
all of these factors reduce human resilience. ATажно правильно
prioritize health and everyday life
habits / activities. Changing them for the better will improve
condition of the body, hence the quality of life.
Although blepharitis is not life threatening
it is necessary to treat it in a timely manner, without delaying therapy on
indefinite term. The sooner you begin to combat pathology,
the lower the risk of chronicity. Therefore, the better the prognosis for
human and his health.
ATопрос: Нужно ли соблюдать диету, если причина
is blepharitis allergic?
No, only if skin inflammation does not occur due to food
product. AT противном случае, придерживаться диеты не имеет
ATопрос: Что делать при появлении признаков
conjunctivitis (dryness of the eye, its redness, increased
AT этом случае, необходимо дополнительно проконсультироваться с
an ophthalmologist who will correct the therapy and prescribe
additional drugs (solution of “artificial tears”,
anti-inflammatory / antibacterial eye drops, etc.).
ATопрос: Можно ли полностью избавиться от
meibomian (regional) blepharitis?
Not usually. The ultimate cause of meibomian dysfunction
not known, therefore, it is not possible to eliminate it.
Patients are advised to undergo symptomatic treatment.
ATопрос: Нужно ли делать массаж век при их
It can not be performed only in ulcerative and demodectic forms.
For the rest, massage is not contraindicated.