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Blepharitis and its Homoeopathic Treatment


Definition:

Blepharitis (blef-uh-RI-tis) is inflammation that affects the eyelids. Blepharitis is a common eye condition, causing the eyelids to be reddened, itchy, and somewhat swollen and scaly-appearing at the base of the eyelashes. As scales become coarser, the surface of the eye becomes irritated and forms crusts, which may cause the lids to stick together when waking up in the morning. If this crust falls into your eye, you may feel like you have "something in your eye" or experience a gritty sensation.

The eyes may become dry due to inflammation of moisture-producing tissues and this can cause a gritty sensation as well. It usually involves the part of the eyelid where the eyelashes grow. It occurs when tiny oil glands located near the base of the eyelashes malfunction. This leads to inflamed, irritated and itchy eyelids. Several diseases and conditions can cause blepharitis. It is often a chronic condition that is difficult to treat. Blepharitis can be uncomfortable and may be unattractive, but it usually doesn't cause permanent damage to eyesight.



Classification of Blepharitis:

There are two types of blepharitis:

1)Anterior blepharitis, when the inflammation affects the outside front edge of your eyelids, where your eyelashes are attached.

2)Posterior blepharitis, when the inflammation affects your Meibomian glands (which are on the inside front edge of your eyelids and produce a fatty liquid that protects your eyes).
Sometimes, people will experience both types of blepharitis because the causes are often connected.

Anterior blepharitis- Many cases of anterior blepharitis are caused by a bacterial infection, usually a staphylococcal infection that is caused by the staphylococcus bacteria. Blepharitis that is caused by this type of bacteria is often known as staphylococcal blepharitis.



Anterior blepharitis can also occur as a complication of seborrhoeic dermatitis (a skin condition that causes your skin to become inflamed or flaky). As seborrhoeic dermatitis is known to cause oily skin, it is thought that the excess oil can irritate the eyelids, providing a breeding ground for bacteria.
Blepharitis that is caused by seborrhoeic dermatitis is often referred to as seborrhoeic blepharitis. It often occurs with posterior blepharitis as well.

Posterior blepharitis- Posterior blepharitis is caused when something affects the Meibomian glands that are found on the rim of your eyelids. These glands are responsible for producing an oily substance that makes up the top layer of your tears. This oily substance is needed to keep your tears in place and protect your eyes.
Blepharitis that is caused by problems with the Meibomian glands is often known as Meibomian blepharitis. Skin conditions, such as seborrhoeic dermatitis and rosacea (a skin condition that mainly affects the face), are known to affect how these glands work.

Seborrhoeic dermatitis- In the case of seborrhoeic dermatitis, the glands produce too much oil. As with anterior blepharitis, the excess oil is thought to provide a breeding ground for bacteria.

Rosacea- In the case of rosacea, not enough oil is produced. However, this is still a problem because your eyes are not being properly protected by your tears, so they also become vulnerable to infection.
About half of people with rosacea will experience associated eye symptoms, such as redness and irritation. Rosacea that affects the eyes is known as ocular rosacea, although this condition is unlikely to develop in people already taking oral antibiotics for rosacea.
Left untreated, ocular rosacea can lead to:
•iritis (uveitis), inflammation of the iris (the coloured part of your eye).
•keratitis, inflammation of the cornea (the transparent outer layer of your eye).


Signs and symptoms:


a)Redness and swollen eyes or eyelids.
b)Flaking of skin on the lids.
c)Crusting at the lid margins, this is generally worse on waking.
d)Cysts at the lid margin (hordeolum).
e)Dry eye.
f)Debris in the tear film, seen under magnification (improved contrast with use of fluorescein drops).
g)Gritty sensation of the eye.
h)Reduced vision.
i)Blurry vision.
j)Burning of the eye.
k)Sensitivity to light.
l)Eyelashes that grow abnormally (misdirected eyelashes).
m)Loss of eyelashes.

Causes:

Blepharitis involves the eyelid margins, where the eyelashes grow and the openings of the tiny oil glands near the base of the lashes are located. There may be involvement of the outer edges of the eyelid margins adjacent to the skin or/and the inner edge of the eyelid that comes into contact with the eyeball. Changes in the skin of the eyelids or the surface of the eye itself are usually secondary to the underlying disorder of the lid margins.
The cause of most cases of blepharitis is a malfunction of the oil glands of the lids. There are about 40 of these glands in each of the upper and lower lids. When these oil glands produce too much, too little, or the wrong types of oils, the eyelid margins can become inflamed, irritated, and itchy. Acnerosacea, a generalized illness of oil glands, is sometimes the underlying cause of this process.

There are some types of blepharitis that are due to disorders of the lid margin around the lashes. These include seborrheic blepharitis, which is similar to dandruff of the scalp, and infection of the lash base by Staphylococcal bacteria.

Allergies can also cause blepharitis. These include sensitivities to substances coming into direct contact with the lid margins, including mascara and contact lens solutions. Various sprays, exposure to animals, environmental chemicals, or airborne allergens can also cause blepharitis.
Less commonly, inflammation of the lids can be caused by a primary infection of the eyelids by bacteria or infestation of the lashes by tiny mites or head lice.

Complication:

• Eyelash problems. Blepharitis can cause your eyelashes to fall out or grow abnormally (misdirected eyelashes).
• Eyelid skin problems. Scarring may occur on your eyelids in response to long-term blepharitis.
• Stye. A stye is an infection that develops near the base of the eyelashes. The result is a painful lump on the edge or inside of your eyelid. A sty is usually most visible on the surface of the eyelid.
• Chalazion. A chalazion occurs when there's a blockage in one of the small oil glands at the margin of the eyelid, just behind the eyelashes. The gland can become infected with bacteria, which causes a red, swollen eyelid. Unlike a sty, a chalazion tends to be most prominent on the inside of the eyelid.
• Excess tearing or dry eyes. Abnormal oily secretions and other debris shed from the eyelid, such as flaking associated with dandruff, can accumulate in your tear film — the water, oil and mucus solution that forms tears. Abnormal tear film interferes with the healthy lubrication of your eyelids. This can irritate your eyes and cause dry eyes or excessive tearing.
• Chronic pink eye. Blepharitis can lead to recurrent bouts of pink eye (conjunctivitis).
• Injury to the cornea. Constant irritation from inflamed eyelids or misdirected eyelashes may cause a sore (ulcer) to develop on your cornea. Insufficient tearing could predispose you to a corneal infection.

Prognosis:
Good hygiene (regular cleaning of the area) can control signs and symptoms of blepharitis and prevent complications. Good eyelid care is usually sufficient for treatment. Such a routine needs to be convenient enough to be continued lifelong to avoid relapses, as blepharitis is often a chronic condition. One episode, however, does not signify that you have a lifelong condition.
If your blepharitis is linked to an underlying cause such as dandruff or rosacea, treating those conditions may alleviate the blepharitis.
In patients who have multiple episodes of blepharitis, the condition rarely disappears completely. Even with successful treatment, relapses are common. Taking the time to devote extra attention to good hygiene at those times may help to control the condition.


Prevention:

There are many everyday steps that you can take to prevent blepharitis. This includes:
• Keeping your hands and face clean.
• Avoiding rubbing your eyes with dirty fingers or a dirty towel.
• Removing all eye makeup before bedtime.
If you are in the early stages of treating blepharitis, avoid the use of eye makeup to prevent further irritation. Once you begin using makeup again, replace your products used in or near the eyelids because they may be contaminated.

Homeopathic Treatment:

Antimonium Crud: Best remedy for Chronic Blepharitis especially in children. The symptoms are redness and inflammation of eyelids, mucus in canthi especially in morning with dry crusts on lids.

Argentum met: This is useful in ulcerative blepharitis, with violent itching of lids & corners.

Argentum Nit: Chronic ulceration of margin of lids, sore, thick, swollen.

Belladonna atropa: Conjunctiva is red and dry with photophobia. Lids are swollen and pupils dilated.

Borax: Chronic form of blepharitis, especially where in eyelashes turned inward, lids cut against eyeball.

Clematis: Chronic form of marginal Blepharitis with sore and swollen meibomian glands. Heat in eyes and sensitive to air, must close them.

Euphrasia officinalis: It is good for eyes that are burning and tearing, with inflamed eyelids and, possibly a feeling of pressure. Discharge of Acrid matter, thick & excoriating. Take one dose of Euprasia 12x or 6c three times a day for up to three days.

Graphites: The most indicated remedy for seborrheic blepharitis. Intolerance of artificial light, lids are red and swollen. Dry, fissured lids with eczema.

Hydrastis: Is good for eyelids that appear infected. Swollen lids, profuse smarting and burning secretion. Take one dose of Hydrastis 12x or 6c three times a day for up to three days.

Lycopodium: Ulceration & redness of lids.

Medorrhinum: Ulcerative Blepharitis. Lids irritated.

Merc sol: One of the great remedy for seborrheic blepharitis. Lids red, thick, swollen. Profuse, burning, acrid discharge.

Petroleum: Useful in marginal blepharitis. Loss of eyelashes. Skin around eye dry and scurfy.

Phytolacca: If the eyelids are swollen and feel hard. Take one dose of Phytolacca 2x or 6c three times a day for up to three days.

Platanus: For both Acute & Spoiled cases of blepharitis, especially where destruction of eyelid tissues occurred and scars tissue caused marked deformity of eyelids. Apply the tincture.

Pulsatilla nigricans: Thick, profuse, yellow and bland discharges. Aching, itching and burning. Profuse lachrymation from the inflamed eyelids & agglutinated. Worse in a warm room.

Staphisgaria: Blepharitis and chalazion due to reoccurring blepharitis especially when underlying Cause is infection.

Sulphur: Burning ulceration of margin of lids.

Tellurium: The eyelids are thickened & inflamed with pustules, pale, red, edematous and oozing. The meibomian glands are involved due to infection. Patient feels that “if the lashes of lower eyelids were turned in”.

DrKunwar Shatrughan
(Dr.Kunwar’s Multispeciality Homoeopathic Centre”
Tohana, Distt.Fatehabad. Haryana.
Email- dr.kunwarshatrughan@hotmail.com

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