Frequent Asked Questions

Orbital & Oculoplastics


Q. What is blepharitis?

Answer. Blepharitis is a common condition that causes inflammation of the eyelids. The condition can be difficult to manage because it tends to recur.

Q. What other conditions are associated with blepharitis?

Answer. Complications from blepharitis include:

Stye: A red tender bump on the eyelid that is caused by an acute infection of the oil glands of the eyelid.

Chalazion: This condition can follow the development of a stye. It is a usually painless firm lump caused by inflammation of the oil glands of the eyelid. Chalazion can be painful and red if there is also an infection.

Problems with the tear film: Abnormal or decreased oil secretions that are part of the tear film can result in excess tearing or dry eye. Because tears are necessary to keep the cornea healthy, tear film problems can make people more at risk for corneal infections.


Q.  What causes blepharitis?

Answer. Blepharitis occurs in two forms:

Anterior blepharitis affects the outside front of the eyelid, where the eyelashes are attached. The two most common causes of anterior blepharitis are bacteria (Staphylococcus) and scalp dandruff.

Posterior blepharitis affects the inner eyelid (the moist part that makes contact with the eye) and is caused by problems with the oil (meibomian) glands in this part of the eyelid. Two skin disorders can cause this form of blepharitis: acne rosacea, which leads to red and inflamed skin, and scalp dandruff (seborrheic dermatitis).


Q. What are the symptoms of blepharitis?

Answer.Symptoms of either form of blepharitis include a foreign body or burning sensation, excessive tearing, itching, sensitivity to light (photophobia), red and swollen eyelids, redness of the eye, blurred vision, frothy tears, dry eye, or crusting of the eyelashes on awakening.


Q. How is blepharitis treated?

Answer. Treatment for both forms of blepharitis involves keeping the lids clean and free of crusts. Warm compresses should be applied to the lid to loosen the crusts, followed by a light scrubbing of the eyelid with a cotton swab and a mixture of water and baby shampoo. Because blepharitis rarely goes away completely, most patients must maintain an eyelid hygiene routine for life. If the blepharitis is severe, an eye care professional may also prescribe antibiotics or steroid eyedrops.

When scalp dandruff is present, a dandruff shampoo for the hair is recommended as well. In addition to the warm compresses, patients with posterior blepharitis will need to massage their eyelids to clean the oil accumulated in the glands. Patients who also have acne rosacea should have that condition treated at the same time.


Q. What is Blepharospasm?

Answer. Blepharospasm is an abnormal, involuntary blinking or spasm of the eyelids.


Q. What causes Blepharospasm?

Answer. Blepharospasm is associated with an abnormal function of the basal ganglion from an unknown cause. The basal ganglion is the part of the brain responsible for controlling the muscles. In rare cases, heredity may play a role in the development of blepharospasm.


Q. What are the symptoms of Blepharospasm?

Answer. Most people develop blepharospasm without any warning symptoms. It may begin with a gradual increase in blinking or eye irritation. Some people may also experience fatigue, emotional tension, or sensitivity to bright light. As the condition progresses, the symptoms become more frequent, and facial spasms may develop. Blepharospasm may decrease or cease while a person is sleeping or concentrating on a specific task.


Q. How is Blepharospasm treated?

Answer. To date, there is no successful cure for blepharospasm, although several treatment options can reduce its severity.

In the United States and Canada, the injection of Oculinum (botulinum toxin, or Botox) into the muscles of the eyelids is an approved treatment for blepharospasm. Botulinum toxin, produced by the bacterium Clostridium botulinum, paralyzes the muscles of the eyelids.

Medications taken by mouth for blepharospasm are available but usually produce unpredictable results. Any symptom relief is usually short term and tends to be helpful in only 15 percent of the cases.

Myectomy, a surgical procedure to remove some of the muscles and nerves of the eyelids, is also a possible treatment option. This surgery has improved symptoms in 75 to 85 percent of people with blepharospasm.

Alternative treatments may include biofeedback, acupuncture, hypnosis, chiropractic, and nutritional therapy. The benefits of these alternative therapies have not been proven.

Entropion (Eyelid Turning In) is the term to describe rolling inward of the lower eyelid and eyelashes towards the eye. The skin of the eyelid and the eyelashes rub against the cornea (the front part of the eye) and conjunctiva (the mucous membrane that protects the eye). This rubbing can lead to excessive tearing, crusting of the eyelid, mucous discharge, irritation of the cornea,

impaired vision, and a feeling that something is in the eye.

Ectropion (Eyelid Turning Out) is the general term to describe sagging and outward turning of the lower eyelid and eyelashes. This rubbing can lead to excessive tearing, crusting of the eyelid, mucous discharge and irritation of the eye. During blinking, the eyelids normally sweep across the surface of the cornea. Tearing occurs because the eyelids are not able to wipe the surface of the cornea properly to pump the tears into the tear duct.

Most cases of entropion and ectropion are due to relaxation of the tissues as a result of aging.


National Eye Institute

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