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Lid hygiene for blepharitis treatment

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Blepharitis is an inflammatory condition of the eyelids. Oils and other products normally secreted by the eye build up on the lid surface and eyelashes, resulting in symptoms of eye irritation, dryness, fluctuations of vision and often redness of either the eyelid margin or whites of the eyes. Although we often must use a combination of many forms of treatment, including an eyelid hygiene regimen, punctual plugs, restasis, lubricating drops, antibiotic pills and topical antibiotic drops and/ointments, the mainstay of therapy is always careful cleaning of the eyelids including the margins and lashes to remove the irritating substances.
To obtain the best results, please follow the instructions listed below, preferably twice a day. Remember blepharitis is a skin condition that may be with you a lifetime although it can wax and wane similar to an eczema, acne or a psoriasis skin condition. The treatment is aimed at minimizing your symptoms and making you more comfortable. Regular lid hygiene should become a part of your daily routine.


Soak a clean face cloth in water as warm as the lids can stand and then apply it to the closed lids for a 5 to 10 minute period. You may need to re-warm and your cloth repeatedly. This will not only feel good, but will make the lids oil and encrustations easier to remove.


Following the warm compresses, clean the eyelid margins with either (1) a clean, slightly moistened thin cotton terry washcloth or dry, slightly abrasive four by four non-sterile gauze pad pulled tightly over your index finger, then using your finger to actually manually scrub the eyelid margin or (2) a dry tightly wad cotton bud (Q tip) that you hold tightly in between your fingers (thumb, index and middle fingers) to also manually scrub the eyelid margins. Do not use cotton balls. These methods will manually remove the debris from the eyelids and eyelashes. If you are using an ointment or drop medications as well, do both the warm compresses and lid scrubs first and then apply the ointment or drops.


Dry eyes may require the addition of frequent eye lubrication drops also called

Artificial tears. These come both with and without preservatives and we recommend preservative free drops if using them frequently. These drops are great for treating foreign body sensation, dryness, intermittent clouding of vision and early contact lens intolerance but don’t generally last more than 15 minutes. Punctal plugs and/or restasis medication may be necessary to enhance treatment of this associated condition.


If an antibiotic ointment has been prescribed by your doctor, this should be applied following the warm compresses and lid scrubs. Place a small amount of ointment on your fingertips (about 1/8th of an inch) and rub it into the lid margin and lashes. This should be placed on both the upper eyelid margins right along the lash line.

Having followed the steps outlined above, we would expect the redness and irritation to be improved, although not necessarily completely gone within 2 to 8 weeks of starting treatment. To stop treatment altogether will probably result in a recurrence of problems of the more severe problems.

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