Blepharitis: symptoms, treatment

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.

Predisposing factors

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
    atopic dermatitis;
  • 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
disease.

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.

Scaly (seborrheic)

xtieqxfnsq-ktafhbnCause возникновения: Точно не
is known, but most likely its development is associated with genetic
feature of immunity and skin. It is very important to pay
attention to the presence of psoriasis in a patient or in his family,
seborrheic dermatitis and neurodermatosis.

Механизм развития: AT настоящее время, считается, что
the main role in the onset of symptoms belongs to the autoimmune
inflammation. It is a condition in which cell defenders (leukocytes)
begin to “make mistakes” and attack normal tissue. AT данном случае
– epithelium of the eyelids.

Infectious (ulcerative)

zdtyysq-ktafhbnCause: Гноеродные микробы –
Staphylococcus, hemophilic bacilli (influents), Moraksella. AT
In some cases, viruses act as the causative agent.
herpes

Механизм развития: Попадание микроорганизмов в незаметные
eye injury, can cause them to multiply and damage
surrounding tissue. If a в роли возбудителя выступает бактерия,
there is the likelihood of its toxins (or the cells themselves) in
blood and intoxication development.

Allergic

fkkthubxtcrbq-ktafhbnCause
возникновения: Наследственная особенность иммунитета, которая
turns an ordinary person into allergies. Exacerbation of the disease
provoked by the action of a certain substance to which it has
patient sensitivity.

Механизм развития: Этот процесс имеет циклический характер.
The exacerbation of symptoms is manifested by close contact with the allergen.
As already mentioned, it can be anything – dust, wool,
cosmetics, impurities in water, etc.

Demodectic

ltvjltrjpysq-ktafhbnCause:  Микроскопический
mite Demodex Folliculorum (native name – Acne
Zheleznitsa), which “colonizes” the channels of meibomian glands.

Механизм развития: Попадание паразита в дерму – еще не
guarantee of development of demodectic blepharitis. To make signs
the disease is clearly manifested, it must multiply and close the duct
glands. Stimulate ticks to grow can:

  • Hot ambient temperature (baths, saunas,
    arid climate, etc.);
  • Lack of adequate hygiene (washing the face several times in
    day, removal of pollutants);
  • The weakening of the body.

Regional (WITHиноним – дисфункция мейбомиевых желез)

rhftdjq-ltvjltrjpCause: Нарушение работы желез,
located in the thickness of the eyelids, in which increases
the amount of fluid (secretion).

The mechanism of development of blepharitis is not completely clear. Probably,
excessive effect on the state of tissues
amount of secretion and local inflammation.

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.

Scaly (seborrheic)

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
blepharitis include:

  • 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
assign:

  1. 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;
  2. 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;
  3. 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.

Infectious (ulcerative)

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;
  • Itching;
  • 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
    surrounding tissue.

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
in yourself:

  1. 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
    epithelial formations;
  2. 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;
  3. ATосстановление обмена веществ в эпителии. WITH этой целью пациенту
    назначают примочки с раствором Цинка WITHульфата (достаточно
    0.25%).

Microbes are the most common. the cause of the development of blepharitis in
children. They respond well to treatment and rarely go into
chronic forms.

Allergic

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:

  1. Analyze the time of onset of symptoms and detect
    contact with any factor (flowering, contact with dust or
    pets, etc.);
  2. 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,
    Chloropyramine;
  • 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
help.

Demodectic

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
    desquamated epithelium;
  • 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.
    microorganism;
  • Conventional therapy does not affect the course of the disease.
    no influence.

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
local application:

Drug name Operating principle Release form
Benzyl benzoate Potent anti-tick agent that acts
as a poison for the parasite, accumulating in its body.
10% ointment
Uniderm Renders anti-inflammatory effect, eliminates part
symptoms and reduces skin damage.
Cream
Emolium A positive effect on the metabolism in the dermis and restores
epithelium.

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.

Regional

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
the pupil.

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.

Forecast

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
    external factors;
  • 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
    treat;
  • 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.

FAQ

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
meaning.

ATопрос: Что делать при появлении признаков
conjunctivitis (dryness of the eye, its redness, increased
fatigue)?

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.
described above.

ATопрос: Нужно ли делать массаж век при их
defeat?

It can not be performed only in ulcerative and demodectic forms.
For the rest, massage is not contraindicated.

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