What is Anterior Blepharitis? Causes & Treatment | Eye Love Cares
Anterior blepharitis is most commonly the result of a Staphylococcus bacterial infection. There are different types of blepharitis and sometimes they overlap. Find out if anterior blepharitis is to blame and how to treat it. Before we get into more details about Anterior blepharitis, we are going to explain what blepharitis is.
Anterior blepharitis is one of many types of blepharitis. Blepharitis is a very common condition that affects the eyes and the eyelids. When you have blepharitis, your eyelids become moderately to severely inflamed. Blepharitis can be easy to treat, but for many patients, it recurs multiple times.
This condition causes the eyelids to become itchy, red, and irritated. It can also cause particles that resemble dandruff to accumulate on the eyelashes. Blepharitis can be caused by bacteria, allergens, and existing skin conditions such as rosacea. Luckily, blepharitis is not contagious in most cases. It also does not usually cause any lasting or permanent damage to your vision or eyesight.
If you are dealing with a case of blepharitis, you are not alone. A group of optometrists and ophthalmologists from the United States revealed in a survey that 37-47% of their patients have been treated for blepharitis. There are even more people who choose to treat their blepharitis symptoms through the use of home remedies without the supervision of a healthcare professional. Blepharitis affects individuals of all ages, ethnicities, and genders.
Anterior Blepharitis vs. Posterior Blepharitis
There are two main categories of blepharitis–posterior blepharitis and anterior blepharitis. Each type of blepharitis stems from different causes and may require varying treatment options and remedies. Sometimes the causes of posterior and anterior blepharitis overlap or occur simultaneously, which results in mixed blepharitis.
Posterior blepharitis mainly affects the eyelid’s inner edge. This is the area of the eyelid that comes in contact with the eyeball. It is also the section of the eyelid that contains the most liquid moisture. Posterior blepharitis is generally a sign that there is a problem with your eyes’ meibomian glands, which are responsible for producing the oily component of the tear film.
Generally, posterior blepharitis is most common in people who also suffer from skin conditions such as scalp dandruff and/or acne rosacea.
Read More on Posterior Blepharitis Here
If your blepharitis symptoms occur along the outer front edge of the eyelids where your eyelashes are attached, it is likely due to anterior blepharitis. Anterior blepharitis is most commonly the result of a Staphylococcus bacterial infection. It can also be caused by allergens such as Demodex mites. Just as scalp dandruff can cause posterior blepharitis, it can also be a contributing factor to anterior blepharitis. Keep reading to learn more about the symptoms, causes, and treatment options for anterior blepharitis.
Read More on Anterior Belpharitis Here
What are the symptoms of anterior blepharitis?
Anterior blepharitis has a number of uncomfortable symptoms. The most noticeable symptom of anterior blepharitis is crusting of the eyelashes. This is most noticeable after waking up from a nap or a night of sleep. In some cases, the crusting can make it difficult to open your eyes as they become glued together by the crust.
Other symptoms of anterior blepharitis may include:
- Redness and swelling of the eyelids
- Sensitivity to light
- Blurry vision
- A gritty sensation in the eye
- Misdirected or missing eyelashes
- The feeling of foreign debris in the eye
- Crusting along the eyelash line
- Tearing or watery eyes
- Frothy tears
- A burning sensation
Symptoms of Specific Forms of Anterior Blepharitis
Anterior blepharitis can be further categorized into different types according to the exact cause of your condition. Each form of blepharitis can have varying symptoms.
Staphylococcal blepharitis causes the eyelids of the margins to become thicker, sticking eyelids, and misdirected or missing eyelashes.
Seborrheic blepharitis leads to scales or oily flakes forming around the base of the eyelashes. It can also cause redness and irritation of the eyelids.
Ulcerative blepharitis caused hard crusts to develop along the eyelashes. It can also cause the eyelashes to become matted. Removing these crusts can result in sores that may bleed or ooze. This form of blepharitis can cause extensive eyelash loss, misshaping of the eyelids’ front edges, excessive tearing, and in extreme cases, an inflamed cornea.
Meibomian blepharitis develops due to a blockage of the eyelids’ oil glands. This causes a poor quality of tears and redness and irritation of the lining of the eyelids.
What causes anterior blepharitis?
Anterior blepharitis can be caused by a number of contributing factors. One of the main causes of this condition is a Staphylococcus bacterial infection. These bacteria exist in considerable quantities on the eyelids and face, however, an excessive growth of the bacteria, or a negative reaction to it, can lead to anterior blepharitis. Dry eye syndrome can also contribute to the development of anterior blepharitis as an insufficient level of the lipid layer of the tear film can make the eye area more prone to the bacterial infection.
Dandruff accumulation on the scalp and within the eyebrow hairs can lead to a form of anterior blepharitis known as seborrheic blepharitis. You can also face an infestation of Demodex mites within the eyelashes that leads to anterior blepharitis.
Dermatologic Risk Factors for Anterior Blepharitis
Although it is not a direct cause of anterior blepharitis, individuals who suffer from the skin condition, acne rosacea are more likely to contract both anterior and posterior blepharitis. 20% to 42% of all blepharitis sufferers also suffer from acne rosacea. This is due to a few common facial components that contribute to both conditions, including:
- Prominent sebaceous glands
Causes of Seborrheic Blepharitis & How it Impacts Anterior Blepharitis
Seborrheic dermatitis is another skin condition that can be a major risk factor for anterior blepharitis, specifically seborrheic blepharitis. Around 33% to 46% of all blepharitis patients also suffer from seborrheic dermatitis. This condition results in symptoms such as flaking and excessive oiliness in the scalp and other areas including the glabella and nasolabial folds.
This skin condition is highly prevalent in people who have seborrheic blepharitis, with over 90% of patients also suffering from seborrheic dermatitis. Seborrheic blepharitis is a form of anterior blepharitis that is associated with greasy or oily eyelid deposits, conjunctival injections, and epithelial erosions. This form of blepharitis does not usually have an effect on the eyelashes. It mostly causes an effect on the anterior region of the eyelids. These symptoms include itching, redness, and irritation.
Anterior Blepharitis Caused by a Demodex Infestation (Demodicosis)
An infestation of Demodex Brevis and Demodex folliculorum eyelid mites is a less common cause of anterior blepharitis. This condition causes cylinder shaped dandruff particles or sleeves to develop on the eyelashes. Demodex infestations have been observed in up to 30% of chronic blepharitis patients. The infestation and waste products that come from the Demodex mites can lead to blocked follicles and glands in the eye area. This causes inflammation within the area.
On average, a healthy person will have up to 2,000 Demodex mites on their body. They usually do not present a problem until they over accumulate and leave visible debris in the eyelid area. Demodex infestations are more likely to cause anterior blepharitis in patients over the age of 60 years old. It also affects individuals who suffer from acne rosacea at a higher rate.
This form of anterior blepharitis features symptoms including itching along the margins of the eyelids and the chronic loss of eyelashes. Doctors usually diagnose anterior blepharitis with a Demodex mite infestation after the condition has proven to be unresponsive to other treatment options.
Other Conditions That Are Associated with Anterior Blepharitis
There are quite a few medical and ocular conditions that can increase your risk of developing anterior blepharitis or may result from an untreated case of anterior blepharitis. These conditions include:
- Tear film production issues
- Dry eye syndrome
- Seborrheic dermatitis
- Meibomian cysts
- Damage to the cornea
These conditions can lead to moderate to severe eye symptoms. Continue reading to learn more about the causes and warning signs of these conditions.
A sty is a tender, red lump that can develop on the eyelid that can develop due to the eyelids’ oil glands becoming mildly infected. The Staphylococcus bacterial infection that causes anterior blepharitis can also cause the development of a sty. Stys cause symptoms such as swelling and the production of pus. They usually occur along the base of the eyelash in or near the eyelash follicle.
A sty can be treated by using a warm compress over the area. If your sty does not get better at trying treatment options, then you may need to visit your doctor or an optometrist. A healthcare professional can drain the sty using a sterile needle.
An untreated sty can develop into a chalazion. This is a firm bump that is caused by an inflamed oil gland within the eyelid area. Chalazia are usually painless, but they can become painful and red if they are accompanied by a bacterial infection.
Tear Film Production Issues
Anterior blepharitis can negatively affect the production of a healthy layer of tear film. A healthy layer of the tear film is needed to protect your eyes from bacteria, allergens, and debris. Anterior blepharitis that affects the oil glands can lead to insufficient oil secretions which further result in teary or watery eyes or eye dryness. This increases your risk for developing a corneal infection.
Untreated anterior blepharitis, especially if it is caused by a Staphylococcus bacterial infection, can lead to an inflammation of the conjunctiva, which is medically termed as conjunctivitis. The conjunctiva is a clear membrane that covers the white area of the eyeball as well as the inner surface of the eyelid.
When bacteria from the eyelids infiltrate and infect the eyes, conjunctivitis occurs. Although this condition is uncomfortable, it is easy to treat and does not usually present any lasting dangers to your vision. Conjunctivitis usually passes within a couple of weeks, but if the condition persists for longer than two weeks, then you should contact your doctor or eye care specialist for medical treatment options. Your doctor may need to write you a prescription for an antibiotic treatment to fight the infection.
Furthermore, it is best to avoid wearing contact lenses and eye makeup when dealing with conjunctivitis.
Dry eye syndrome
Dry eye syndrome is another condition that is closely related to anterior blepharitis. This condition can lead to anterior blepharitis. Plus, it can develop as a result of anterior blepharitis. Dry eye syndrome affects over half of all patients who suffer from anterior blepharitis that has been caused by a staphylococcal infection. This condition is also related to conjunctivitis as it can be caused by the same bacteria. It is believed that the eye’s sensitivity to this bacterium is caused by a lowered level of lysozyme and immunoglobulin, which are both necessary for proper tear production. This increases the risk factors for anterior blepharitis, conjunctivitis, and dry eye syndrome.
There is an increased risk for dry eye syndrome in individuals who are suffering from a form of anterior blepharitis called seborrheic blepharitis. Anywhere from 25% to 40% of seborrheic blepharitis patients also suffer from dry eye syndrome. This is likely due to higher levels of evaporation in the tear film that occurs due to an insufficient level of the tear film’s oily component.
Dry eye syndrome and anterior blepharitis are both the result of your eyes not producing enough healthy tears. A healthy tear film protects the eyes from bacteria, allergens, and debris. Dry eye syndrome can cause your eyes to feel gritty, sore, and dry. It can also cause your eyes to become excessively watery as they attempt to make up for the dryness.
Seborrhoeic dermatitis is a skin condition that can increase your chances of developing anterior blepharitis, as it affects many areas of the skin. This condition causes oily and flaky skin throughout the body, including along the anterior area of the eyelids. It is helpful to keep this area moisturized and clean.
Meibomian cysts cause swelling on the inside of the eyelids. This can cause cysts to develop in the Meibomian glands, which are responsible for producing the oily component of the tear film. This happens when the Meibomian glands become inflamed due to blepharitis.
Uninfected Meibomian cysts are usually pain-free. However, you may experience pain if your cyst becomes infected. If your Meibomian cyst becomes infected, then it is best to pay a visit to your doctor or eye care specialist. They will prescribe an antibiotic treatment to fight off the infection. For an uninfected Meibomian cyst, you can apply warm compresses to reduce the swelling.
A Meibomian cyst will usually disappear over time. If it does not, then a healthcare professional can perform a simple procedure under local anesthetic to remove the cyst.
Damage to the cornea (Keratitis)
Severe or untreated cases of blepharitis can cause damage to your cornea, which is the transparent layer that forms the front of the eye. The inflammation, redness, and irritation that accompanies anterior blepharitis can cause damage to the cornea’s surface. This damage is called keratitis.
Anterior blepharitis can cause the cornea to become more susceptible to infection and ulceration. This can lead to permanent damage to the eyes and have a lasting negative impact on your vision. In addition, it can cause serious pain.
Keratitis is a very serious medical condition that requires immediate medical attention. You should contact your doctor or eye care specialist if you notice any of the following symptoms:
- Damaged vision
- Extreme sensitivity to light
- Sudden, intense eye pain
How is Anterior Blepharitis Diagnosed?
There are a number of ways that anterior blepharitis can be diagnosed. Sometimes, individuals who suffer from anterior blepharitis can diagnose it on their own due to the common, easily identifiable symptoms. For instance, crusting of the eyelids, inflammation of the eyelids, redness, and itching. While anterior blepharitis can be self-diagnosed and self-treated, this is not recommending for severe and chronic cases of the condition.
If your anterior blepharitis symptoms worsen or do not get better with home treatment, then it is best to pay a visit to your doctor or an eye care specialist. They can give you a proper diagnosis and prescribe or recommend more effective treatment options.
A healthcare professional will perform a comprehensive eye examination that focuses on the eyelids and the eyeball’s front surface. This examination may include:
- An examination of the margins of the eyelids to determine whether you have anterior blepharitis, posterior blepharitis, or a mix of both.
- An evaluation of the quality of the tear film to check for the presence of all of the necessary components.
- An evaluation of your medical history to check for a history of other conditions that contribute to the contraction of anterior blepharitis such as dry eye syndrome, conjunctivitis, seborrheic dermatitis, Demodex infestation, and tear film production issues.
- An examination of the external areas of the eye including the surface of the eyelid, skin texture, and the appearance of the eyelashes.
- A thorough, magnified examination of the base of the eyelashes as well as the meibomian gland.
What are the Best Treatment Options for Anterior Blepharitis?
Each form of blepharitis can have varying symptoms, which means that each case of this condition will require unique treatment options. While there are some basic treatment options, such as improved eyelid hygiene, that can alleviate the symptoms of many forms of blepharitis, the severity and specific causes of your condition may require different additional treatment methods.
Currently, there is no cure for blepharitis. However, with effective treatment options from a trusted healthcare professional, this condition is easily treatable. It is helpful to understand the different forms of anterior blepharitis in order to best manage this common eye condition.
If your case of anterior blepharitis is the result of a bacterial infection, you will most likely need to use some form of antibiotics in order to treat the condition. Your doctor or eye care specialist may prescribe an antibiotic treatment in the form of a pill, topical ointment, or antibiotic eye drop. The use of antibiotics can be a huge help in fighting off the infection, which will, in turn, alleviate the accompanying symptoms of anterior blepharitis.
If your doctor chooses to prescribe an antibiotic ointment to treat your blepharitis, then you should be cautious while applying it in order to avoid allowing this product to come into direct contact with your eyes. Be sure to apply this treatment option using a clean cotton swab, or Q-tip, in order to apply the treatment only to the base of your eyelashes. This treatment option may be prescribed in addition to an oral antibiotic medication.
Artificial tears are an effective treatment option for both anterior blepharitis as well as dry eye syndrome, which may accompany or worsen your blepharitis symptoms. Prescription artificial tears are great for alleviating symptoms such as redness, inflammation, and dry eyes. There is also antibiotic eye drop formulas that help with the proper production of oil from the Meibomian glands.
Topical steroids relieve anterior blepharitis symptoms by alleviating ocular inflammation. For this treatment option, a corticosteroid eye drop formula or ointment is applied multiple times a day in order to reduce the inflammation of the eyelids. Most eye care specialists recommend that you use a minimal dose over a short period of time in order to avoid complications such as cataracts and increased intraocular pressure.
There are a few prescriptions that combine steroidal and antibiotic ingredients for the most effective treatment option. This is a great option for mixed blepharitis that may be caused by multiple factors.
Applying a warm compress to your eyelids is another treatment option for anterior blepharitis. The first step for using a warm compress to treat your anterior blepharitis is to wet a clean washcloth with warm water. Once your washcloth is wet, wring it out to remove any dripping water. For a warm compress, the washcloth should be damp rather than wet before application. After your washcloth is damp, close your eyes and place the washcloth over your eyelids for a minimum of one minute. You may need to repeat the process of wetting the cloth and wringing it out in order to keep it warm. Warm compresses are great for loosening the crusty substance that accumulates around the eyelashes, causing them to stick together.
In addition, you can purchase a gel mask to use as a warm compress for treating anterior blepharitis. A gel mask can be warmed in the microwave and usually does not need to be repeatedly warmed as often as a washcloth warmed with water. Warm the gel mask in the microwave for 10-15 seconds in the microwave and apply it to your eyelids for about four to eight minutes.
Improved Eyelid Hygiene
One of the best at home treatment and prevention methods for anterior blepharitis is to maintain good hygiene by keeping the eyelids and eyelashes clean and free of crusts and debris. Blepharitis rarely goes away completely, so it is important to continue your eyelid hygiene routine even when the blepharitis symptoms aren’t present. You can use a mild cleanser such as baby shampoo or an eyelash wash to clean the area with a cotton swab. To make the crusts easier to remove, you may want to precede your cleaning method by a warm compress.
If you have a form of anterior blepharitis that is caused by dandruff, then the use of anti-dandruff shampoo is good to include in your hygiene routine. You can also massage your eyelids to clean the oil that may accumulate in the meibomian glands. Patients who are also dealing with acne rosacea should have that condition treated in addition to other anterior blepharitis treatment methods. When you are suffering from anterior blepharitis, it is best to limit or eliminate the use of eye makeup, as this will make it difficult to clean your eyelids thoroughly.
After applying a warm compress and gently cleaning your eyelids, it is great to perform an eyelid massage to alleviate your anterior blepharitis. To perform an eyelid massage, begin by using a clean index finger to firmly press your eyelid against your eyeball. For an eyelid massage that effectively alleviates your anterior blepharitis symptoms, you should massage for four seconds in four different areas on each upper and lower eyelid. An eyelid massage can cause blurred vision for a few seconds, but it will provide some relief to your blepharitis symptoms.
A good addition to your eyelid massage is castor oil, which is naturally anti-inflammatory, anti-bacterial, and anti-fungal. These properties are excellent for alleviating a variety of forms of blepharitis. Adding castor oil to your everyday eye care hygiene routine in order to prevent future cases of blepharitis.
Treating Anterior Blepharitis Caused by a Demodex Mite Infestation
When you are treating anterior blepharitis that has been caused by an infestation of Demodex mites, one of the most effective treatment options is the use of tea tree oil with a concentration of 40% to 50%. A lower concentration may be used, but a concentration of over 50% is usually too strong for most people. There are many treatment kits available that contain a proper solution of tea tree oil as well as a brush for gently scrubbing the eyelid and eyelash area.