There are many causes of dry eyes. These include:

 

• Hormonal imbalance

• Poor health

• Drug side effects

• Long periods of computer use

• Pregnancy

• Hayfever

• Blocked mybomium glands

• Blepharitus

• Demodex paracite

• Allergies

• Contact lens wear

 

BLEPHARITIS

 

Blepharitis is a condition where the edges of the eyelids become inflamed (red and swollen). 

It is a common condition, accounting for an estimated 1 in 20 eye problems reported to Opticians. Blepharitis can develop at any age, but is more common in people over 40.

 

Signs of blepharitis can include:

 

• itchy and sore eyelids

• eyelids that stick together and are difficult to open, particularly when you wake up

• eyelashes that become crusty or greasy

 

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When to see your Optician?

 

See your Optician if you are unable to control the symptoms of blepharitis with simple cleaning measures alone (see below).

Your Optician can usually diagnose blepharitis based on your symptoms and an examination of your eyes.

What causes blepharitis?

Blepharitis can be caused by an infection with Staphylococcus bacteria, or as a complication of a skin condition, such as:

 

• Seborrhoeic Dermatitis – a condition that causes the skin to become oily or flaky

• Rosacea – a condition that causes the face to appear red and blotchy

• Demodex Infection

 

How blepharitis is treated?

 

Blepharitis is usually a long-term condition. Most people experience repeated episodes, separated by periods without symptoms.

Blepharitis cannot usually be cured, but a daily eyelid-cleaning routine that involves applying a Eye Bag – gently massaging your eyelids and wiping away any crusts with Blephaclean or Blephasol – can help control the symptoms. 

More severe cases may require antibiotics that are either applied to the eye or eyelid directly, or taken as tablets

 

Complications

 

Blepharitis is not usually serious, although it can lead to a number of further problems.

For example, many people with blepharitis also develop dry eye syndrome (a condition where the eyes do not produce enough tears or dry out too quickly), which can cause your eyes to feel dry, gritty and sore.

Serious, sight-threatening problems are rare, particularly if any complications that develop are identified and treated quickly.

 

What is Demodex?

 

Demodex is the name given to tiny mites that live in the hair follicle. In humans, Demodex are found on facial skin especially the forehead, cheeks, sides of the nose, eyelashes and external ear canals. The condition it causes is called demodicosis and are associated with Rosacea. There are two mites principally involved in human Demodex infestations, Demodex folliculorum and Demodex brevis. D folliculorum is found in small hair follicles, particularly the eyelashes. In both its immature and adult stages it feeds on skin cells. D. brevis is found in the oil glands that are connected to small hair follicles and feeds on the gland cells. D. folliculorum mites are 0.3-0.4mm in length and D. brevis 0.15-0.2mm. This makes them invisible to the naked eye but under the microscope their structure is clearly visible. The 8 legs of this mite move at a rate of 8-16 mm/h and this is mainly done during the night as bright light causes the mite to recede back into the follicle.

 

Who has demodicosis?

 

Human Demodex mites are found mostly on older children and adults and rarely in children under 5 years old.

What are the clinical features of demodicosis?

Patients with demodicosis may have eye irritation, itching and scaling of eyelids (eyelid dermatitis). There may be lid thickening, loss of lashes, conjunctival inflammation and decreased vision. It has not yet been established if Demodex is responsible for any skin diseases but increased numbers of Demodex mites have been observed in the following conditions: ‘Pityriasis folliculorum’ – rough, dry and scaly skin Rosacea, particularly asymmetrical papulopustular or granulomatous variants Some cases of perioral dermatitis Blepharitis (inflammation of the eyelid margins).

 

 How is Demodex found?

 

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Demodex may be found in mineral oil skin scrapings from the face by KOH examination, or in a skin biopsy examined under the microscope.

 

What is the treatment for demodicosis?

 

Demodex can only live in the human hair follicle and when kept in check they cause no problems. Thus treatment is aimed at trying to control proliferation of Demodex mites. Many treatments involve spreading an ointment at the base of the eyelashes at night to trap mites as they emerge from their burrow and move from one hair follicle to another. A current popular treatment is to firstly debride the lashes and lash roots with scrubs and then treat the area with Blephasol or Blephagel. Home treatment and prevention strategies include: Cleansing the face twice daily with a non-soap cleanser Avoiding oil-based cleansers and greasy makeup Exfoliate periodically to remove dead skin cells *It is particularly NOT advised to use baby shampoos on or around the eyes as this will damage the tear film and further irritate the lids.  

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