Blepharitis Guide

How to Treat
Blepharitis & Eye Allergies

And Live Symptom Free
Published by Ten Doves Charity
Author: Dr. S. Banerji
How to Treat Blepharitis and Eye Allergies
-
2
nd
Edition
Dr. S. Banerji Page 2 TenDoves.org

About the Study

!

The purpose of this guide was to review numerous medical and scientific
studies, articles, journals, and surveys as well as certain non-medical, non-
scientific information about the subject of blepharitis and eye allergies
(our Research) and present an objective summary (Guide). This Guide
provides information about blepharitis and eye allergies based on our
Research and the consensus opinions of the professionals that contributed
to the Guide.

This Guide was authored by a doctor and provides comprehensive
information about blepharitis and eye allergies in easy to follow language
that is meant to supplement information from your doctor not replace it.
Do not read this Guide unless you agree to the Terms & Conditions on the
Ten Doves website and below:

Terms & Conditions of use of the Guide: By downloading and opening this Guide, you (the
donor or recipient of the Guide) signify that you have read and agree to these Terms &
Conditions of use of the Guide:
1. All information in the Guide is meant to supplement information from your doctor
not replace it. This Guide must not serve as a substitute for a professional medical
examination, advice and treatment. Rather, it was written to help you understand
fundamental aspects of blepharitis and assist you in communicating with your doctor
to manage the condition optimally. Your doctors advice should always take
precedence, and you must abide by his/her instructions and prescriptions even if
they contradict information contained therein.
2. You agree to indemnify and hold harmless Ten Doves and all related persons against
any damage, liability or expense arising from use of the information contained in the
Guide.
3. The Guide is the intelletual property of Ten Doves - all rights reserved. It is provided
to you for personal use only and shall not to be copied, re-sold, or re-distributed to
anyone else.
4. Any legal claim must be filed within one year of your first download of the Guide,
shall be governed by binding arbitration, and filed in Collin County Texas only.
5. If you do not agree to these terms do not read the Guide - send an email to
support@tendoves.org for a refund.
-
2
nd
Edition

Table of Contents

!

Chapters Page

Introduction............................................................................................................................. 4
Chapter 1 Diagnosis......................................................................................................... 6
Chapter 2 Posterior Blepharitis.................................................................................... 9
Chapter 3 Anterior Blepharitis ................................................................................... 13
Chapter 4 Other Related Conditions........................................................................ 15
Chapter 5 Eye Allergies................................................................................................. 16
Chapter 6 Treatment ..................................................................................................... 18
Chapter 7 Prevention of Reoccurrences................................................................. 30
Conclusion.............................................................................................................................. 32
About the Author................................................................................................................. 33
About the Publisher ............................................................................................................ 33

-
2
nd
Edition

Introduction

!

The term blepharitis refers to various types of inflammation and infection
affecting the eyelids, eyelid margins, eye lashes, and meibomian glands.

Blepharitis is a common eye disorder throughout the world. It is more
common in 3
rd
world countries but it is found everywhere. It can occur
with children but more typically affects adults. Causes include working or
living in a dirty environment and poor hygiene, but it doesnt necessarily
have to. That is because few people are aware of the importance of eyelid
hygiene. Often the first time they hear the terms blepharitis and eyelid
hygiene is from an eye doctor that has diagnosed the condition.

There are numerous symptoms (below) and causes (illustrated on the
right) that overlap.

Symptoms of blepharitis include:
Itching and/or burning of
the eyes
Redness of the eyes and
eyelids
Flaking of skin on the lids
Foamy or frothy discharge
from the eyes
Crusting at the lid margins (particularly after waking in the morning)
Foreign Object Sensation in the eyes
Dry eye sensation in the eyes
Reduced vision
Sensitivity to light (oncoming headlights at night)
Plugged or partially plugged meibomian glands
Blephospasms
Loss of eye lashes
Excess tearing
Infection
Allergy Irritants
-
2
nd
Edition

Unfortunately, blepharitis is typically a chronic condition that has no cure,
but it can be managed with long-term eyelid hygiene and medicine.
Blepharitis is not contagious and when properly treated does not usually
cause permanent eye damage.

Blepharitis is often classified into two types:
Posterior Blepharitis (affecting the insides of the eyelids and lid
glands)
Anterior Blepharitis (affecting the outsides of the eyelids and eye
lashes)

This Guide explains how blepharitis is diagnosed and each type in detail. It
also explains treatment options, homeopathic and herbal remedies, and
prevention of re-occurrences. It also describes eye allergies that can often
accompany, contribute to, or create similar symptoms of blepharitis.
-
2
nd
Edition

Chapter 1 Diagnosis

!

Professional Diagnosis

Do you know the difference between an optometrist and an
ophthalmologist? When most people think of eye doctors they think of
optometrists. An optometrist is a health care professional who is licensed
to provide primary eye care services for vision correction including eye
glasses and contact lenses. They also examine and diagnose eye diseases
such as glaucoma, cataracts, and retinal diseases and other problems. An
optometrist will recognize the symptoms of blepharitis, however, one
should be referred to or seek out an ophthalmologist for treatment of this
condition.

An ophthalmologist is an eye M.D., a medical doctor who is specializes in
eye and vision care. Ophthalmologists are trained to provide the full
spectrum of eye care, from prescribing glasses and contact lenses to
complex and delicate eye surgery. They may also be involved in eye
research. After 4 years of medical school and at least one year of
internship, each ophthalmologist spends a minimum of 3 years of residency
(hospital-based training) in ophthalmology. During residency, the eye M.D.
receives special training in all aspects of eye care, including prevention,
diagnosis and medical and surgical treatment of eye conditions and
diseases. An ophthalmologist may spend additional time training in a
subspecialty of a specific area of eye care as well.

Based on their education and training, ophthalmologists are universally
cited throughout the Research as the best medical professional to diagnose
and treat blepharitis. Ophthalmologists can be located in your area from
referrals from optometrists, the Yellow Book, and from the Internet.

Your appointment with an ophthalmologist will include a full eye
examination including a check of vision acuity, color, stereopsis, near point
of convergence, pupils, visual field screening, pressure and other tests.
-
2
nd
Edition

The eye doctor will examine the health of the eye and eyelids using a slit
lamp biomicroscope and fluorescein staining. This microscope has an
attached light that allows the doctor to examine the eye under high
magnification to examine the cornea, iris, lens, and eyelid structure. He or
she may also press on the eyelids to detect blocked eyelid glands and an
oozing of oil indicating clogged meibomian glands. There is no single
specific test for blepharitis, but if you have it, the ophthalmologist will be
able to diagnose it. If anterior blepharitis is suspected, the doctor may
order a lab culture test.

An illustration a normal eye versus one with blepharitis is below:

Notice the white bumps at the eyelid margin representing plugged glands.
Also notice how the inflammation is causing the eye to appear red and
inflamed.

Blepharitis is generally classified into the following types and sub-types:

Posterior Blepharitis (affecting the insides of the eyelids and lid
glands)
o Meibomian Gland Dysfunction (MGD)
o Mixed (MGD mixed with anterior Blepharitis)
Anterior Blepharitis (affecting the outsides of the eyelids and eye
lashes)
o Staphylococcal
o Seborrheic
o Mixed (with each other and/or posterior Blepharitis)
-
2
nd
Edition

MGD involves the posterior eyelid margin (inside the eyelids by the base of
the eyelashes). Seborrheic and staphylococcal Blepharitis involve mainly
the anterior eyelids (outside the eyelids and at the base of the eye lashes).
There is considerable overlap of symptoms of all types of Blepharitis. It
also frequently leads to associated ocular surface inflammation, including
conjunctivitis, functional tear deficiency, and keratitis.

Blepharitis symptoms are almost always bilateral and symmetric meaning
it occurs in both eyes equally or near equally. Symptoms in one eye only
may indicate a different and possibly more serious condition.

Patients reported in the Research that extended periods of computer use,
TV watching, or reading, contributed to their condition. This may be a
function of less blinking while doing these activities, as the eye lashes were
designed to help screen out particulates before entering the eyelids.
People suffering from allergies also reported higher percentages of the
Blepharitis condition.

Blepharitis can have onset at any age, but is most frequently first
experienced by middle-aged adults. In two studies, patients with MGD and
seborrheic Blepharitis were generally older and had a longer history of
symptoms (range 6 to 11 years). Patients with staphylococcal Blepharitis
had mean ages of 43 and a relatively short history of symptoms (2 years).

The following chapters describe each type of Blepharitis in detail.
-
2
nd
Edition

Chapter 2 Posterior Blepharitis

!

Meibomian Gland Dysfunction (MGD)

The conditions that lead to MGD include a build-up of dirt, oil, and dead
skin around the eyes over a period of time. This provides a breeding
ground for bacteria that blocks the eyelid glands ultimately causing this
condition. Most people are not taught about eyelid hygiene until it is too
late. Even people with excellent hygiene might not know that they have to
make extra daily cleaning efforts around the eye sockets, eye lids, eye
brows, bridge of the nose and entire facial area.

Without regular proper eyelid hygiene is it fairly easy, and in fact quite
common, to get MGD. Living or working in dirty areas enables this
condition as does certain drug use and allergens. Chronic cases have been
linked to environmental factors such as chemical fumes, smoke, and smog.
Some people with particularly dry facial skin are prone to this condition
since a build-up of dry dead skin around the eyes contributes to this
condition. Improving your environment by reducing allergens will help. A
few examples include washing pillow cases and bed sheets daily, using and
changing indoor air quality filters, and getting allergy tests (further
discussed in Chapter 5).

The eyelids have oil secreting glands at the eyelid margin called meibomian
or tarsal glands. The naturally produced oil mixes with tear drops to cover
the eyeball reducing friction between the eyeball and the back of the
eyelids. The oil keeps the teardrops from evaporating too quickly. Normal
eye drops containing the proper amount of oils will remain on your eyeball
between 10 and 15 seconds before breaking up and evaporating. Without
the oil, natural tears will break up and evaporate in less than 10 seconds.

Ironically, some patients believe that they are suffering from a dry-eye
condition when in fact they have MGD. That is because when the
meibomian glands are plugged, producing less than normal oils, the tear
-
2
nd
Edition

glands actually produce more tears than normal in an attempt to
compensate, but without sufficient oils these tears evaporate too quickly.

Your eyes and eyelids are complex the anatomy is illustrated below.

-
2
nd
Edition

Look for the meibomian (tarsal) glands in the above illustration they are
small delicate passages inside the eyelid (posterior), under the eyelashes,
which can clog easily. They are illustrated in blue because a normally
functioning gland will secrete oils from the bottom and middle of the gland
out through the small opening when you blink.

When you pull your lower eyelid down with your finger, the meibomian
glands open at the very edge between the inner and outer eyelid. If you
look with a 10X magnification eye-makup mirror, you can see the small
openings and the whitish glands that run up the inside of the eyelids
towards the openings at the end.

Clogged, inflamed or blocked eyelid glands reduce the amount of natural
oils available to mix with tear drops to lubricate the eye. When this
happens, friction is created causing discomfort and small flakes of skin can
rub off of the back of the eyelids further clogging the eyelid margins. If
untreated, this will add to the build-up of bacterial growth that inflames the
eyelids and affects its appearance and texture.

Plugged meibomian glands have a yellow or white cap of crustation over
the gland. A picture of these caps appears below from RootAtlas.com, and
the link to this video from Youtube.com is also below.
-
2
nd
Edition

http://www.youtube.com/watch?v=p4l6NwxKSGo&feature=related
(if link does not work, search youtube.com for meibomian glands)

Notice that the doctors finger is pressing downwards on the lower eyelid
margin exposing the tops of the meibomian glands. You can clearly see
the white pustules on top of each gland. A normally functioning gland
would not be plugged or capped. If the cap were soft enough, the doctor
could press on the gland removing the cap and expressing the built-up
fluids in the gland. When the gland is infected with bacteria the expressed
fluids will appear milky or yellow in color instead of the normal clear color.
-
2
nd
Edition

Chapter 3 Anterior Blepharitis

!

Staphylcoccal Blepharitis

Staphlycoccal Blepharitis is caused by infection of the anterior portion of
the eyelid (outside of the eyelids at the base of the eyelashes) by
staphylococcal bacteria. As the infection progresses, the sufferer may
notice inflammation, a foreign body sensation in the eyes, loss or matting
of the lashes, and stinging. The condition can sometimes lead to a more
serious chalazion or stye.
This condition is diagnosed based on the patient's medical history and a
bacterial culture. Middle-aged women appear in the Research to be more
susceptible to this condition than men.
The presence of a ring-like formation around the eye-lash shaft can be
observed by the doctor using a slit-lamp microscope. This is the primary
sign of this condition. Other specific symptoms include loss of eye-lashes,
matting, or broken eyelashes.

If left untreated, this infection may spread to other parts of the eye or to
the scarring of the cornea. This condition may or may not be accompanied
by MGD or seborrheic Blepharitis.

Seborrheic Blepharitis

People with seborrheic Blepharitis typically have soft greasy scales and eye
lashes along the length of the eyelid margin. Eye-lashes tend to clump and
stick together. Sufferers tend to be older and it affects men and women
equally.

Certain skin conditions such as eczema, dermatitis, seborrhea, and
dandruff can contribute to seborrheic Blepharitis. Most people exhibit one
-
2
nd
Edition

or more of these conditions on their scalp, forehead, neck, back of neck,
back of ears and in the folds of the elbows and knees.

Regular long-term smoking or exposure to heavy second hand smoke can
contribute as well. This condition may or may not be accompanied by MGD
or staphlycoccal Blepharitis.

-
2
nd
Edition

Chapter 4 Other Related Conditions

!

Occular Rosacea

This condition is characterized by erythema (redness) of the cheeks, nose
and/or forehead. Pustules may be found along the eyelid margin and there
may be infection of the cornea. If untreated, it can lead to lid scarring and
eyelid misdirection.

Occular Rosacea is more common in women but is usually more severe in
men.

Psthiriasis Palpebrarum

This condition is an infestation of the eye-lashes by crab lice. The lice
attached to the base of the eyelids and lay eggs that appear as small white
or brown pearls.
-
2
nd
Edition

Chapter 5 Eye Allergies

!

Eye Allergies

The conjunctiva of the eyelids are some of the most sensitive tissues on
our body. For many people, the environment causes allergic reactions that
can accompany or mimic symptoms of Blepharitis such as red eyes,
itching, watering, foreign body sensation and many others.

For chronic Blepharitis sufferers we recommend a thorough examination by
a qualified allergist physician. In addition to a visual check, they will likely
order a full spectrum allergy test. This test is done by two methods:

Scratch Test This test involves drawing a checker-board across
your back creating 80 or more squares. The technician then applies
80 different allergens, one drop at a time in each square. The
allergens are samples of things that typically cause allergic reactions
such as grasses, pollen, dust, animal hair, etc. The technician then
uses a sharp sterile instrument to scratch the skin below each drop
with sufficient depth to cause the fluid to permeate the outer layers
of the skin. During a 30 minute observation period, the technician
and doctor will notice and record your bodys reaction to each
allergen ranking each from 0 5, with 5 being the biggest reaction.

Blood Test Blood is drawn and sent to a laboratory for further
allergic testing. Often this is done to verify certain results from the
scratch test or to test something that wasnt included in the panel.
For example, if a person owns a particular type of animal or breed of
animal, a blood test can verify how allergic they are to that specific
animal.

-
2
nd
Edition

Eye Allergies Contributing to or Mimicking Blepharitis?

It is important to determine whether a patient has Blepharitis without eye
allergies, Blepharitis with eye allergies, or eye allergies that are mimicking
the Blepharitis condition. I make this distinction because the treatments
are different. For example, the typical first line of defense for Blepharitis is
an eyelid hygiene program including eye-lid scrubs. While effective for
Blepharitis, it could make eye allergies worse.

Ask your ophthalmologist if he or she thinks that eye allergies could be
contributing to your condition, and then see an allergist. Once diagnosed,
treatments by allergists usually involve changing things in your
environment, diet, and getting immunology shots. This is explained in the
next chapter.

-
2
nd
Edition

Chapter 6 Treatment

!
Treatment Regimen for Blepharitis

Performing immediate eyelid hygiene is the first step to recovery from both
posterior and anterior blepharitis. This is accomplished with a series of at-
home treatments explained below.

Use a warm moist terry washcloth applied to the eyelids to loosen
crusted secretions.

o Hold the warm wet cloth over your eyes for 5 minutes, 3 times
a day. The temperature should be shower warm to hot but
not scalding hot. The heat, moisture, and pressure will loosen
and remove the scales, oil, grime and other impediments at the
base of the eyelashes.

o Next rub the washcloth horizontally across the outside of the
eyelids, back and forth, about ten times. Your eye-lid margins
are very delicate so do not rub too hard, just enough so you
can lightly feel the cloth to remove loose particles and grime.
Once you have completed one eye, flip the cloth over and use
the other side for the second eye. Try opening your eyes
slightly while you are rubbing them so the terry cloth fibers can
cleanse the eyelid margin at the base of the eyelashes. The
terry cloth has a sufficiently fibrous texture to scrub away the
unhealthy materials, but be sure to rub the eyelids only and
not the eye surface itself.

o For additional cleansing you can try adding diluted baby
shampoo to the washcloth. Many peoples eyes are sensitive to
baby shampoo, however, and if you have a negative reaction
discontinue its use; it can be helpful but is not necessary.
-
2
nd
Edition

o As the final step, take a cotton swab and gently press the tip
against the outside of the eyelids near the very end, pressing
up towards where the Meibomian glands exit at the margin (a
10X magnification makeup mirror is helpful). You are gently
messaging the glands by pushing up and through the outside of
the eyelids, not the inside. It should only take about 30
seconds to do the lower and upper lids, and then, gently pull
the end of a new swab laterally across the tops of the margin
lids removing any materials that were expressed through the
tops of the glands. It is important that you do these
techniques gently.

Some people get better results using special eyelid cleanser instead
of, or in addition to, the terry cloths. They come in individually
packed pads with cleaning solution, and cleaning foams. One
popular brand is called OCuSOFT which comes in an original formula
and a Plus formulation enhanced to help eliminate bacteria.
Sometimes the doctor prescribes a specially formulated eyelid
cleanser to clear the lash area of crusts and scaling. OCuSOFTs line
of eyelid hygiene products appears below, and most of these
products can be found at your local pharmacy.

www.ocusoft.com/products

-
2
nd
Edition

For seborrheic blepharitis caused by certain skin conditions such
eczema, dermatitis, seborrhea, and dandruff, certain over-the-
counter or doctor prescribed medicines are used to treat these
conditions. This may include using a dandruff shampoo such as Head
and Shoulders. T-Gel (both in regular and extra strength formula)
and T-Gel conditioner are stronger solutions effective in treating
these conditions and are excellent when alternated with Head and
Shoulders.

If lice are the cause of the symptoms, petroleum jelly can be applied
along the base of the eyelashes to eliminate them, or one can obtain
over-the-counter or doctor prescribed ointments.

Prescriptions

For stubborn cases, eye doctors typically prescribe a more aggressive
regimen using prescription medicines, in addition to the eyelid hygiene
techniques above. These include:

STERIOD DROPS: Steroid eye drops may be used to treat
inflammation and help eliminate foreign materials. These are
typically prescribed over a 3 - 4 week period, 4 drops per day. If you
are taking steroid drops, it is important to strictly adhere to your eye
doctors orders. During this period the eye-doctor will perform tests
to check the pressure in your eyes. Prolonged use may cause
increased pressure in the eyeball with certain patients, which could
lead to cataracts, glaucoma or other problems. Ophthalmologists
have dozens of prescription medications at their disposal to treat
blepharitis, and several of the more commonly prescribed medicines
reported in the Research are highlighted below:

o FML (fluorometholone ophthalmic suspension, USP 0.1%)
FML, produced by Allergan, contains the active ingredient
fluorometholone. It is a type of medicine called a corticosteroid
(or steroid) used as a topical anti-inflammatory agent for
ophthalmic use. This type of steroid should not be confused
-
2
nd
Edition

with anabolic steroids that have gained notoriety due to their
abuse by some athletes. Corticosteroids are hormones
produced naturally by our bodies (by the adrenal glands) that
have many important functions including control of
inflammatory responses. They work by acting within cells to
decrease the release of inflammatory substances thereby
reducing swelling, redness and irritation. Use only as
prescribed side effects are listed on the manufacturers
packaging.

o Pred Forte (Prednisolone) Pred Forte, preduced by Allergan,
is another type of corticosteroid containing the active
ingredient prednisolone. Prednisolone is a synthetic
corticosteroid that can be administered into the eyes to
decrease local inflammation caused by blepharitis. It is also
sometimes prescribed after eye surgery. Use only as
prescribed side effects are listed on the manufacturers
packaging.

o Zylet (loteprednol etabonate 0.5% and tobramycin 0.3%
ophthalmic suspension) Zylet eye drops, produced by Bausch
& Lomb, is a sterile, multiple dose topical anti-inflammatory. It
is used to treat inflammation caused by surgery, infection,
allergies, and blepharitis. Use only as prescribed side effects
are listed on the manufacturers packaging.

o Alrex (loteprednol etabonate) - Alrex, produced by Bausch &
Lomb is a corticosteroid prescription eye drop used for the
treatment of seasonal eye allergies (allergic conjunctivitis and
others). It has been shown to be effective for treating a wide
range of eye allergy symptoms and for sufferers of blepharitis.
Use only as prescribed side effects are listed on the
manufacturers packaging.

There are numerous other prescription eye drops used for the
treatment of blepharitis as well. Since each patient may react
differently to the various active and inactive ingredients in each, the
eye doctor may utilize a trial-and-error process to determine which
prescription medicine is optimal for a specific patient.
-
2
nd
Edition

General Precautions for using steroid drops:
o If these products are used for 10 days or longer, intraocular
pressure should be monitored by your doctor.
o These products are sterile when packaged. To prevent
contamination, care should be taken to avoid touching the
bottle tip to eyelids or to any other surface. Keep bottle tightly
closed when not in use, do not share with others, and keep out
of the reach of children.
o Wait at least 15 minutes before inserting contact lenses.
o Consult your doctor if you are pregnant or nursing.
o Discontinue use if you suffer adverse reactions and consult with
your doctor.
o Read and follow the instructions on the manufacturers
packaging.

CORTICOSTERIOD OINTMENTS: Corticosteroid ointments are often
prescribed in conjunction with eye drops. These special antibiotic
eye ointments usually contain erythromycin or bacitracin. The
ointment is applied before bed each night and last longer than drops.
This will reduce bacteria on the eyelid margins overnight.

ORAL ANTIBIOTICS: A round of oral antibiotics is usually also
prescribed. This is used to treat any bacteria build-up that might
have contributed to the blepharitis condition. In the Research,
doxycyline and tetracycline are the most often cited prescription
antibiotics for treating blepharitis. They tend to dry the oil build up
in the eyelid glands, in addition to treating the underlying bacteria.
Oral antibiotics are often prescribed for a 60 120 day period which
must be taken for the entire prescribed length of time, or risk
relapse.

ALLERGY, DRY EYE AND LUBRICANT DROPS Prescription and non-
prescription allergy, dry eye, and lubricant drops are often prescribed
in combination with, or after, steroid drops, depending upon the
patient and symptoms for treatment of blepharitis and other
conditions such as conjunctivitis and dry eye. There are numerous
such eye drops with various active and inactive ingredients (different
patients can different reactions to active and inactive ingredients).
-
2
nd
Edition

Such eye drops include Pataday, Zyrtec, Refresh, Optive,
Restasis and many other types and brands.

The above treatment regimen must be performed under the close
supervision of an eye doctor. During your treatment you will have follow
up check-ups to confirm how well you are responding to the hygiene and
prescription treatment, and changes might be made.
Most patient testimonials in the Research reported much improved
comfort and vision within the first four weeks of their eye doctors
treatment, and near normal or normal condition after eight weeks of
treatment.
-
2
nd
Edition

Eye Allergy Treatment

Once an allergist diagnoses a patient with eye allergies he or she will
recommend a treatment plan based upon the patients medical and family
history, medical condition, examination, and the results of the allergy
tests. The treatment plan could include the following:

ENVIRONMENT: You must become aware of the environment around
you in your home, in your car, at your work, and in public places.
There are numerous publications available from doctors, bookstores
and online on how to improve allergies. Below is a summary:
o Home Environment:
! Upgrade your home HVAC filters and change them on a
regularly schedule basis every 30 or 90 days depending
upon the type.
! Have a professional HVAC cleaning performed annually.
! Purchase several mobile air filtration devices place one
next to your bed, near pets, in the kitchen, and in areas
that you spend time in.
! Purchase dust mite covers for your bed and pillowcases.
Clean sheets and pillowcases daily with hot water and
detergent.
! Use anti-allergen cleaning solutions.
! Use anti-allergen shampoo, conditioner, soap & lotions.
! Use anti-allergen shampoo for pets.
! Replace carpeting for wood or tile flooring.
! Keep doors and windows closed to keep out airborne
pollen, grasses and pollutants (important for eyes).
o Car Environment:
! Many cars have cabin air filters (change regularly).
! Clean cabin with anti-allergen cleaners.
! Keep windows closed while driving to keep out airborne
o Work Environment:
! Purchase a mobile air filtration unit.
! Use anti-allergen cleaning solutions for your desk and
work area.
-
2
nd
Edition

! Keep windows closed while driving to keep out airborne
! If you work outside, use wrap-around sunglasses.
o Public Places:
! Avoid smoke filled rooms people are not usually allergic
to smoke but it is a major irritant.
! When outside, use wrap-around sunglasses.

Immunotherapy: The allergist may prescribe allergy shots to boost
your immune system. The theory is to bombard your system with
low doses of the irritants that your body is most allergic to. Over
time, the bodys defenses create increased internal immunities to
these irritants resulting in less severe reactions when you come into
contact to them in the future.
o Their office or lab concocts a set of serums containing 5 50ml
for a series of shots.
o Shots are given in the arm starting with a low dose, twice per
week.
o Shots are increased in strength until reaching the highest level.
o Maintenance shot is given once per month.

Eye Allergy Drops: Pharmaceutical and homeopathic companies have
developed a series of eye allergy drops. You may wish to discuss
these products with your eye doctor, and based on his or her
recommendation, conduct some trials. Some contain blood vessel
constrictors which many eye doctors do not recommend, so be sure
to be through in your investigation and doctor discussions about the
suitability of these products for you.
-
2
nd
Edition

Homeopathic Herbal Remedies and Techniques

The Research indicated various homeopathic & herbal remedies and
techniques people used for dealing with the blepharitis:

Increasing the intake of Omega-3 fatty acids (fish or flaxseed oil
supplements) may reduce the blepharitis inflammation.

N-acetylcysteine (NAC), is an amino acid that enhances the
production of glutathione, one of the body's antioxidant enzymes. In
one study, the effect of 100 mg of N-acetylcysteine orally, three
times each day for eight weeks, resulted in stabilization of tear film
and reduced discomfort from blepharitis.

Several herbs have been traditionally used to treat eye inflammation
including calendula, eyebright, chamomile, and comfrey.

Goldenseal and Oregon grape contain the antibacterial constituent
known as berberine. While topical use of berberine in eye drops has
been clinically studied for eye infections, the use of the whole herbs
has not been studied for blepharitis or conjunctivitis.

For stubborn crusts along the eyelid margins, a more intense
cleansing/vibrating action can be accomplished by wrapping a warm
washcloth around the head of a sonic wave type toothbrush and
rubbed against the outside of the eyelids and margins as described
previously in this Guide. The sonic waves and vibrating action assist
the elimination of crusts. While this technique was reportedly
beneficial for some people, it was also reported as too aggressive for
many others be gentle.

To our knowledge, none of the above homeopathic herbal remedies and
techniques have been medically or scientifically studied for the treatment
of blepharitis. As such, these are presented for informational purposes
only and should only be used with the approval of your eye doctor.

-
2
nd
Edition

Surgical Options for MGD

For the most severe cases of MGD, eye doctors may offer certain patients
relatively new surgical options to open blocked meibomian glands. One
such surgical tool and technique is Fugo blade surgery. The Fugo blade is
a nanotechnology incising device employing plasma. The plasma allows for
bloodless or near-bloodless surgery and ablating small vessels and
capillaries. Fugo plasma ablation has a documented surgical history of
safety with thousands of cases to date.

Our view at this time is that virtually all of the millions of patients that
suffer from the blepharitis and MGD conditions can achieve good results
from the treatments described earlier in the Guide. In our opinion,
patients should exhaust every other possible option before considering
surgery, and then, only under the guidance of a qualified doctor with direct
experience.

A photo of the Fugo blade tip appears on the next page along with a link to
a video from Youtube.com posted by Dr. Daljit Singh, DSC, MS, Amritsar,
India, demonstrating the Fugo blade procedure treating MGD.

-
2
nd
Edition

http://www.youtube.com/watch?v=V99HBOHiR3E
(if link does not work, search youtube.com on meibomian glands and Fugo Plasma)

As you can see from the video, Dr. Singh has anesthetized the patients
eyes, eye sockets, and eyelids. He then used the sterile Fugo plasma
blade to penetrate the top of each blocked meibomian gland, eliminating
blockages and unhealthy material. Pent-up oils are expressed through the
top of each gland.

After the procedure, patients took antibiotics to control infections. Patients
in the Research reported immediate results, but were required to maintain
long-term eyelid hygiene.

-
2
nd
Edition

Some references to patients in the Research suggested the benefits
appeared that they would be permanent or near permanent while others
reported that the MGD condition returned within 6 18 months after the
procedure. To our knowledge, since this is a relatively new procedure and
the long-term benefits have yet to be studied and reported.

Of course, like any surgical procedure, the Fugo plasma blade procedure
must only be performed only by a trained eye doctor familiar with this tool
and procedure, in a jurisdiction that has medically approved this
technology for this use.
-
2
nd
Edition

Chapter 7 Prevention of Reoccurrences

!

While there is no cure for blepharitis, most patient testimonials in the
Research reported much improved comfort and vision within the first four
weeks of their eye doctors treatment, and near normal or normal
condition after eight weeks of treatment.

Once treated, the chances of reoccurrence of the symptoms of blepharitis
are mostly up to you. Living a symptom free life is mostly a factor of
maintaining a consistent and disciplined eyelid hygiene program, a healthy
diet and living environment, limiting exposure to allergens and building
immunities, and managing stress.

Consistency

Consistency of treatment is the key to managing blepharitis and living
symptom free.

Sticking to every bit of your eye doctors treatment plan is very important.
If you are given prescriptions for eye drops, ointments, and/or antibiotics it
is CRITICAL that you finish the fully prescribed amounts. A common
mistake that people make is to begin to feel better and then reduce or stop
the treatments. Dont make this mistake. If you do, the bacteria and
other contributors to the condition can come back with a stronger
resistance to the medicines.

While modern medicine has no final and complete cure for blepharitis, you
can be optimistic that you can control the impact that this problem has on
your life and lifestyle. With proper treatment and preventive maintenance
you can greatly minimize any problems and discomfort.

-
2
nd
Edition

Daily Routine

Blepharitis can become very frustrating for people that have chronic cases.
You must stick to the complete treatment regimen that your eye doctor
prescribes and add this eyelid hygiene regimen to your daily routine just
like brushing your teeth.

Overall good health, diet, sleep, building up your immunities, and
managing stress are also important.
-
2
nd
Edition

Conclusion

!

The term blepharitis refers to various types of inflammation and infection
affecting the eyelids, eyelid margins, eyelashes, and meibomian glands.

Blepharitis is a common eye disorder throughout the world. Causes can
include working or living in a dirty environment and poor hygiene, but it
doesnt necessarily have to. That is because few people are aware of the
importance of eyelid hygiene and dont learn about it until it is too late.

Symptoms of blepharitis include itching and/or burning of the eyes,
redness of the eyes and eyelids, flaking of skin on the lids, crusting at the
lid margins (particularly after waking up in the morning), a foreign object
sensation in the eyes, and greasy clumping or loss of eye lashes. Eye
allergies often contribute to, or mimic, the blepharitis condition.

This Guide describes how blepharitis and eye allergies are diagnosed, and
each type in detail. It also explained treatment options, homeopathic and
herbal remedies, and prevention of re-occurrences.

While there is no cure for blepharitis, one can control the impact of this
problem with proper treatment and continued long-term preventive
maintenance and live symptom free.
-
2
nd
Edition

About the Author

This Guide was authored by Dr. S. Banerji, CBAM, PGDM, MSc, BSc. Dr.
Banerji is a practicing clinical biophysicist in Mumbai, India. He is also an
active researcher and writer of medical articles and guides distributed
worldwide. Illustrations were drawn by Ms. M. Perrine. Ms. Perrine has an
Associate degree in Fine Arts and Pre-allied Health. She specializes in
medical drawings, illustrations, charts and artwork. Any references to any
other trade names or intellectual property belong to their respective
owners.

About the Publisher

This Guide is published by Ten Doves, a 501(c)(3) non-profit organization
that helps children in need and provides research information. All funds
from the sale of this Guide go to Ten Doves Vision Fund. To learn more
about Ten Doves please visit its website located at www.tendoves.org.

Ten Doves Charity
5100 W. Eldorado Pkwy. #102-732
Mckinney, TX 75070
Phone: 469-217-1000
Email: support@tendoves.org

How to Treat Blepharitis and Eye Allergies 2nd Edition Copyright 2011
(1st Edition Copyright 2006)
Ten Doves, a non-profit organization All Rights Reserved

###

Blepharitis Guide

Загружено:

Сведения о документе

Авторское право

Доступные форматы

Поделиться этим документом

Поделиться или встроить документ

Параметры публикации

Этот документ был вам полезен?

Это неприемлемый материал?

Авторское право:

Доступные форматы

Blepharitis Guide

Загружено:

Авторское право:

Доступные форматы

How to Treat

Blepharitis & Eye Allergies

Вам также может понравиться