Blepharitis In Older Adults

Infants and older adults are always prone to infections and diseases easily due to a developing and weakened immune system respectively. 

It is always crucial to look after them with extra care. In this article we will look at a condition called “blepharitis” and its impact on older adults.

What is blepharitis?

Blepharitis is a condition of inflammation in the eyelids. The lids' edges turn red or black, puffy and scaly. Blepharitis typically affects both eyes. It can happen when a skin disease causes irritation when there is an infection, or when the oil glands clog. All of these things can happen at once. Blepharitis is a term for inflammation, however it can also result in an infection in the eye.

Types of blepharitis

There are two forms of blepharitis based on the position of the eyelids. They are:

• Anterior blepharitis
• Posterior blepharitis

Anterior blepharitis occurs when the front exterior of the eyelid, where the eyelashes emerge, is red, deeper in colour, swollen, or when the lashes are covered in dandruff.

Posterior blepharitis occurs when the oil-producing meibomian glands beneath the eyelid secrete thickened/unhealthy oil.

Symptoms of blepharitis:

• Red, irritated eyes
• Dry eyes
• Excessive blinking or excessive tearing
• Crusting of eyelashes and eyelid corners, making the eyelids stick together
• Swollen eyelids and/or greasy eyelids
• Blurred vision
• Loss of eyelashes
• Photophobia (light sensitivity)
• Blurred vision
• Loss of eyelashes¹

Causes of  blepharitis

• Seborrheic dermatitis (dandruff of the scalp and eyebrows)
• Clogged or malfunctioning oil glands in your eyelids
• Rosacea (a skin condition characterised by facial redness)
• Allergies, including allergic reactions to eye medications, contact lens solutions 
• Eyelash mites or lice
• Dry eyes
• Eye makeup²

Diagnosis and treatment

• Examination of eyes. The doctor may examine the eyelids and eyes using a special magnifying device.
• Skin swabs are used for testing. In certain instances, the doctor may use a swab to obtain a sample of the oil or crust that builds on the eyelid. This sample can be tested for pathogens, fungi or signs of an allergy.

Treatment

• Antibiotics: Antibiotics administered to the eyelid have been shown to soothe symptoms and treat bacterial infections of the eyelids. These can take the form of eye drops, lotions or ointments. If the patient does not respond to topical antibiotics, the doctor may recommend an oral antibiotic.
• Medications to treat inflammation: steroid eye drops or ointments are used for this purpose, but only in cases where other treatments are ineffective. Your doctor might prescribe both antibiotics and anti-inflammatory medications.
• Immunomodulatory medications: Topical cyclosporine (Restasis) has been demonstrated to improve some blepharitis symptoms.

Treatments for the underlying disease 

Blepharitis caused by seborrhoeic dermatitis, rosacea, or other disorders may be treated by addressing the underlying cause.³

Warm massage

Wet a clean washcloth with warm water and drain it until it is almost dry. Put the washcloth over your closed eyes for at least one minute. Wet the washcloth as often as needed to keep it warm. This will dislodge the flakes that are stuck around your eyelashes. It also helps to prevent neighbouring oil glands from clogging.

There is also an electronic device that employs heat and massage to clear out the oil glands in your eyelids. the ophthalmologist performs the treatments at their office.

Eyelid scrubs

Dip a clean washcloth, cotton swab (Q-tip), or lint-free pad with baby shampoo diluted in warm water. Then, lightly scrub the base of your lashes. Scrub for approximately 15 seconds. 

Skin and eyelid hygiene

It is critical to keep your eyelids, skin, and hair clean. This will keep your blepharitis symptoms under control. Carefully wash your eyelashes with diluted baby shampoo in warm water every day. Wash your hair, scalp, and brows with antibacterial shampoo. There are several new antiseptic sprays you may use on your skin to prevent bacteria from multiplying too quickly.⁴

Studies on blepharitis in older adults A research study on the prevalence of anterior blepharitis was carried out with a larger ageing population. Examinations included visual acuity assessment, refraction and complete slit lamp examination. Results of a study showed an increased prevalence of anterior blepharitis in elderly people.⁵

Summary

To summarise, blepharitis and its impact on older adults is explored. Blepharitis causes eyelash crusting, irritation and redness, tearing and blurry vision in the eyes. Symptoms, causes, diagnosis and treatment for blepharitis were explored: which included medication prescribed by doctors, eyelid scrubs, eyelid massages manually and mechanically and maintaining eyelid and skin hygiene.