Blepharitis Management


Blepharitis is one of the more common ocular disorders we see on a day-in-and-day-out basis at Kirkwood Eye Center. While we diagnose it daily, a majority of the time when we mention to a patient that they are suffering from this condition, they commonly tell us they have never heard that before. We have found it to be one of the most under-diagnosed ocular conditions.


Blepharitis are tiny collarettes of bacterial excretion (staphylococcus) that sit on the eyelid margin. Left untreated, this can progress and lead to chalazions (styes), corneal ulcers, and meibomian gland atrophy and lid loss. It is also a culprit in many cases of chronic red eyes and dry eye patients.


The Blephex procedure is performed by one of our trained technicians and is a painless process which usually takes about 5-10 minutes to perform for each eye. We use a scale to grade the extent of the blepharitis and demodex. This ranges from a trace amount to a substantial amount (or a grade 4). Once the patient progresses to the point past what we would consider a grade 1 (mild amount), we begin to recommend blephex treatments on a 6-month basis. For patients suffering from trace or grade 1 levels, pharmaceutical management is typically effective.


Demodex is another lid disorder which appears similar in nature to blepharitis. It is due to the demodex mite and also leads to collarettes along the eyelid margin. Treatments for demodex vary, but typically we use products which have a component that utilizes tea tree oil. Wiping the treatment on and allowing it to air-dry on the surface of the eyelids does a wonderful job for keeping the mite under control and maintaining a clean eyelid surface. Some studies have shown nearly a 100% prevalence rate of this mite and collarettes in patients above the age of 80. As the above video references, the Blephex device does an absolutely fantastic job of cleaning the biofilm from the ocular surface as well as aiding in the killing of the demodex mite.


The good news for both blepharitis and demodex is that there have been significant advancements in the past few years which have aided us in the diagnosis, treatment, and management of these conditions. These range from topical antibiotics, oral antibiotics, lid scrubs such as Avenova and Cliradex as well as topical anti-inflammatory drops, and, most importantly, the Blephex device. The Blephex is similar to having your teeth cleaned and performing this procedure every six months does a great job of helping to maintain the integrity of the lid environment.


Blepharitis collarettes tend to be quite small and are often very difficult for patients to see without magnification. If you are concerned for yourself, or if you believe a loved one may be suffering from this manageable condition, please set up an appointment to be seen by one of our doctors.