Blepharitis

Blepharitis means inflammation of the eyelid margins and represents a range of conditions which includes meibomium gland disease (MGD) and ocular rosacea. Blepharitis exacerbates DED by destabilizing the tear film and the two are often experienced together. 

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Blepharitis 1
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What is Blepharitis

The eyelids contain between 20 and 50 meibomium glands which produce the lipid component of the tear film, this is important in allowing tears to spread evenly and also to delay tear film evaporation allowing the eyes to be lubricated for longer between blinks. Blepharitis is associated with MGD in which inflammation plays a prominent role, less lipid of higher viscosity is produced which in turn leads to higher bacterial cell counts and inflammation of the eyelid margins. Symptoms include red rimmed eyelid margins, irregularity of the lid margins, a crusting or a dandruff-like appearance along the eyelids, loss or clumping of eyelashes and the eyelids sticking together on waking. Higher bacterial cell counts along the lids, particularly with Staphlococcus aureus can lead to infections around the meibomium glands causing a chalazion (link to Other Eye Conditions page) also called a meibomium cyst.

People with ocular rosacea will often be aware of red rash or fine telangiectasia in a butterfly distribution across the bridge of the nose and cheeks and just over half will experience symptoms of blepharitis. Ocular rosacea tends to be worse in the 30 – 50 year age group. 

Animation: What is Blepharitis?

Blepharitis and Demodex Folliculorum

Animation: Blepharitis: Demodex

Blepharitis may also be associated with Demodex infestation in which higher concentrations of the mite Demodex folliculorum are found in the eyelash follicles causing loss of the lashes, a dandruff like appearance to the eyelashes and may cause itching of the eyelids and forehead. Demodex infestation is age-related and Demodex mites are present normally at low concentration in individuals who have no symptoms of blepharitis and cause no harm. Tea-tree oil is particularly effective against Demodex but is an ocular irritant so specific ocular preparations are available for treatment, often as pre-soaked eyelid wipes. 

Treatment for Blepharitis

Blepharitis may also be associated with Demodex infestation in which higher concentrations of the mite Demodex folliculorum are found in the eyelash follicles causing loss of the lashes, a dandruff like appearance to the eyelashes and may cause itching of the eyelids and forehead. Demodex infestation is age-related and Demodex mites are present normally at low concentration in individuals who have no symptoms of blepharitis and cause no harm. Tea-tree oil is particularly effective against Demodex but is an ocular irritant so specific ocular preparations are available for treatment, often as pre-soaked eyelid wipes. 

Animation: Blepharitis: Treatment

The LipiFlow® Thermal Pulsation System is an outpatient treatment in which heat is applied to the eyelids which are massaged by rollers from top to bottom. Treatment typically takes around 10 – 15 minutes. 

Animation: LIDS Lipiflow

Medical treatment for blepharitis will involve a course of treatment to reduce ocular surface inflammation and control lid margin Staphlococcus aureus. Longer term treatment can include a course of macrolide antibiotic therapy. As blepharitis is a chronic medical condition it is important to realize that it cannot be cured as such although symptoms can often naturally wax and wane and once controlled, many people can control their symptoms using lid hygiene measures alone.

Managing blepharitis is important in preparing for any eye surgical procedure and also in maximizing the visual results obtained from surgery as disruption of the tear film caused by DED or blepharitis degrades the quality of the optical image before it enters the eye. We will advise you on the best strategies for managing blepharitis either as part of routine surgical management or as part a comprehensive treatment strategy for treating blepharitis and DED. 

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Peter
Excellent result extremely satisfied
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I was extremely short sighted in my left eye minus 10.5 which with appropriate contact lens did still not give me good vision. I had several consultations with David Anderson as I was rather nervous of surgery due to a previous unfortunate experience with my right eye. David had not been involved with my right eye surgery. David was very reassuring and gave me confidence so I went ahead and had the surgery. Excellent result extremely satisfied. I would definitely recommend a consultation.
Juliet
Life Changing Surgery
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Yes cataract surgery is scary but David and his team were wonderful. David listened very carefully to what I wanted to achieve and patiently answered my detailed questions. He worked closely with my optician so that I could try contact lenses of different prescriptions to see which suited me best. In the end I had one eye adjusted for distance/normal vision and one eye for reading. My surgery was 2 months ago and everyone was kind and patient. It took time to get use to my new eyes but I now don't need glassed for the first time since I was 12 years old! I am completely use to my eyes now and don't notice that I have had anything done other than I don't wear glasses which is life changing! I would definitely recommend David and would like to say a BIG Thank You!
Dean
My optician referred me
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I am absolutely delighted with the total lens replacement surgery I had at Anderson Eye Care. From my first consultation with Mr. Anderson, through to surgery and aftercare, my experience was of the highest professional quality. The procedure itself was painless quick and very relaxed. I unreservedly would recommend Mr. David Anderson and his team at Anderson Eye care. I now have 20/20 vision, which speaks for itself!
Peter
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Extremely impressive professional experience from the initial consultation, to the surgery and post operative follow up. An absolute model in every respect for every health care professional to digest. The team atmosphere at Eastleigh Nuffield was brilliant from start to finish. Their team camaraderie is obvious and can’t be faked. My personal outcome is perfect. Many thanks to David and the Nuffield team.
Sharon
Very pleased with cataract procedures
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Mr Anderson has carried out cataract surgery on both of my eyes. I had my right eye done first. A year later, when it was time to have my left eye done, I only wanted Mr Anderson to carry out the procedure. On both occasions I discussed what I wanted the outcome to be, and Mr Anderson delivered exactly. The procedure was painless and quick. I am very pleased with the outcome. I found Mr Anderson and his staff very comfortable and reassuring to be around. I have no reservations in recommending Anderson Eye Care.
Merilyn
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My optician referred me urgently to the Eye Hospital but it was going to be a wait of several months to be seen so I came to David Anderson privately. The initial consultation was reassuring and without pressure and I decided to go ahead with cataract surgery. It worked well having the eyes done a week apart and was an easy experience. I had a worry after the second one and was seen quickly and reassured about it. All is well now.
Gareth
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I was referred to Mr Anderson by my optician. I found him to be extremely personable and professional and was immediately reassured by his calm manner. He recommended refractive lens exchange, in both eyes. I was a little apprehensive pre op, but all the staff were reassuring, and the op itself was painless, and over very quickly. (probably around 15 minutes) I could see the results almost immediately. 4 weeks on and after 55 years of spectacle wearing the results are amazing. From a prescription of +9.5 I am now completely glasses free even for reading. Thank you
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Happy 20/20 Vision!!!!
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I am absolutely delighted with the total lens replacement surgery I had at Anderson Eye Care. From my first consultation with Mr. Anderson, through to surgery and aftercare, my experience was of the highest professional quality. The procedure itself was painless quick and very relaxed. I unreservedly would recommend Mr. David Anderson and his team at Anderson Eye care. I now have 20/20 vision, which speaks for itself!
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