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Inflamed eyelids: symptoms, causes and treatment
Inflammation of the eyelid, also known as blepharitis, includes various forms of eyelid inflammation, which can be attributed to different causes. The disease often occurs at the same time as other inflammatory processes on the eye. Good eyelid hygiene and naturopathic measures often help to relieve the symptoms. If the symptoms do not go away or if the course is chronic, a visit to the doctor and further therapy measures are necessary.
A brief overview
The most important facts about the symptoms and treatment measures are summarized below. The further article describes the clinical picture of blepharitis comprehensively and provides further information.
Most of those affected have swollen and red eyes (eyelids). Burning eyes and itchy eyes often occur. With certain and mostly infectious forms of disease, eyelids and eyelashes stick together, especially after getting up. Other symptoms on the eyes and skin may also occur. The severity and course is different and ranges from very mild complaints to severe eye damage.
What can you do?
In the case of an acute inflammation, the symptoms are often quickly relieved by careful daily hygiene measures on the eye. Medicinal plants, such as eyebright, can also support the healing process. If the symptoms do not subside, worsen or keep coming back, a medical examination should take place. Further therapeutic measures, possibly also using antibiotics or virustatics, may be necessary.
The Greek term blepharitis describes the so-called eyelid inflammation (rarely eyelid inflammation) as a medical generic term for various forms of inflammation of the eyelids, and especially their edges. If the respective cause or the exact location of the inflammatory focus is known, the disease can be further specified. For example, inflammation in the area of the eyelid angle is referred to as angular blepharitis and can therefore be distinguished as a special form. Many other forms of disease are differentiated in this way.
Infections can trigger eyelid inflammation. But other non-infectious causes are also possible, such as external stimuli, functional disorders of the eye or allergic reactions and other diseases. In addition to an acute onset, this can also lead to chronic courses with recurring or permanent complaints.
Depending on the causes, the respective manifestation and the severity, different symptoms can occur with an eyelid infection. The symptoms are similar to those of dry eyes or other eye infections. Also conjunctivitis (concomitant conjunctivitis, blepharoconjunctivitis) and a dry eye often occur simultaneously with the inflammation of the eyelids.
Most forms of blepharitis show swollen and red eyes (lids). Together with a frequent burning sensation and itchy eyes, this sometimes leads to a strong foreign body sensation in the eye. It is also often reported of glued eyelids and eyelashes after getting up. In the further (chronic) course, these signs of the disease may increase or, in certain more serious forms, further symptoms may appear.
So the list of all possible symptoms is long. The following complaints are typical and relatively common symptoms:
- reddish eyelids and eyes,
- Swelling on the edge of the eyelid and eye,
- burning and itchy eyes,
- Foreign body sensation in the eye,
- Photosensitivity (photophobia),
- Scale formation on the edge of the lid and eyelashes,
- Glandular secretions and greasy deposits on the edge of the eyelids that stick and crust over the eyelids and eyelashes
- Malposition (trichiasis) or loss of eyelashes (madarosis), as well as waxing of eyelash-like hair from the meibomian glands (distichiasis),
- Eye fatigue and visual impairment.
Blepharitis can have many different causes, which determine the shape and course of the disease. A distinction is often made between acute and chronic, but also between infectious and non-infectious inflammation of the eyelid.
The eyelids contain different glands. The secretions are part of the tear fluid and grease the edges of the eyelids. Bacterial infections, secretion build-up or functional disorders of the glands lead to pathological changes in the sense of eyelid inflammation relatively often. The most common causes include infection with staphylococci, seborrhea (overproduction of fats by sebaceous glands) and malfunction of the meibomian glands. While the staphylococcus is an acute bacterial infection, the other two causes are non-infectious and are associated with chronic blepharitis. External stimuli or other underlying diseases can also cause or promote inflammation of the eyelids.
In most cases, bacterial infections are the cause of acute, ulcerative inflammation of the eyelid. Infections with staphylococci are most common, but other bacteria or viruses (e.g. herpes simplex virus) are also considered pathogens. As a rule, eyelids that are glued and encrusted yellowishly appear with bacterial infections. If viruses are the cause of the disease, clear, liquid secretions are secreted.
Staphylococci are part of the normal skin flora, also on the edge of the lid. If the immune defense is weakened, normal colonization can be disturbed and become out of balance. Various enzymes and toxins, which are produced by the increasing number of staphylococcal bacteria, can then lead, among other things, to disorders of the tear film and the sebum-producing glands, which in turn can cause inflammation of the eye.
If allergic reactions trigger acute blepharitis, these are usually not ulcerating on the edge of the eyelid, but lead to pronounced itching and rashes, such as with atopic blepharodermatitis (neurodermatitis on the eye).
Chronic blepharitis is usually a malfunction of the meibomian glands. These glands produce an oily fluid (lipids) that regulates and slows the evaporation of the tear fluid. If the function is disturbed to the extent that the lipid composition is changed, there are also changes in the secretion and thus clogged gland exits. In many people affected by this meibomian gland dysfunction, a recurring grain of barley (hordeolum) or hail grain (chalazion) is a possible consequence. Another consequence of the glandular dysfunction is faster tear evaporation, which can lead to dry eyes (keratoconjunctivitis sicca).
In many cases, the skin disease rosacea is associated with disorders of the meibomian glands and eyelid inflammation. Typical symptoms of rosacea are red spots on the face and flaky skin. With ocular rosacea, the skin near the eye and eyelids is affected, possibly without other symptoms on other skin areas.
A secondary bacterial infection often develops on the skin flakes on the edge of the lid. If there is an inflammation of the lids with scaling, this is called blepharitis squamosa. Excessive fat production (seborrhea) can also lead to blockage of the glands and corresponding inflammation of the eyelid (seborrheic blepharitis). Many sufferers then also suffer from seborrheic dermatitis or acne (acne rosacea).
It is not uncommon for several causes to be responsible for the development of an eyelid inflammation. If there is seborrhea, a staphylococcal infection and dry eyes (Sicca syndrome) in particular, this is also known as the triple S syndrome.
Furthermore, external stimuli are considered non-infectious risk factors that can favor the development of blepharitis. For example, the skin and eyes can be irritated by drafts, extreme temperatures, smoke, dust or chemical substances (in cosmetics), which leads to an increased risk of illness.
In rare cases, it is suspected that parasites (such as eye mites or pubic lice) could also be involved in the development of eyelid inflammation (blepharitis parasitaria).
For the precise diagnosis of an eye infection, a detailed examination of the eye and the edges of the eyelids is carried out during the specialist examination after the patient consultation (medical history). A slit lamp is usually used for this purpose, which makes it possible to view the eye and the pathological changes in a large magnification. A swab can usually be used to determine whether it is an infection. However, it is not always possible to make a precise diagnosis. In this way, the causes of an inflammation of the eyelid remain unknown, even after a thorough examination.
Inflammation of the eyelid is a relatively common disease and does not always require a doctor's visit or medical treatment. The disease often has only mild symptoms and is quickly cured even without further medical care. Daily, thorough eyelid hygiene and measures from herbal medicine (phytotherapy) in many cases lead to a quick relief from the symptoms.
In principle, medical advice should be sought if the symptoms that occur (despite our own measures) persist or worsen over several days and impair those affected too much. A medical examination and, if necessary, appropriate therapy should also take place in the case of constantly recurring and permanent inflammation.
More complex therapeutic measures are usually necessary and effective when infections with bacteria or viruses have caused acute ulcerating blepharitis. Appropriate eye drops or ointments containing antibiotics or antivirals are usually used. Treatment with cortisone may be an option for acute, allergic eyelid inflammation.
The treatment of chronic blepharitis mostly focuses on the sequelae or symptoms and causes of the triggering (skin) diseases. For example, tear substitutes can help alleviate the symptoms of dry eyes.
Eye hygiene plays a major role in healing
In order to support the healing process for eye infections as well as possible, daily hygiene and care measures for the eyes and face are essential. It is recommended to use these measures before any further medical treatment. They are also important accompanying measures during therapy.
Those affected are advised to put a warm (not too hot) cloth or a warm gel mask on their closed eyes every day for about ten minutes and then gently massage the eyelids with their hands (and cotton swabs). It should always be stroked in the direction of the eyelashes, i.e. from top to bottom for the upper eyelid and from bottom to top of the lower eyelid. If a yellow-white secretion emerges, it should be carefully removed with cotton swabs. If there is stubborn secretion or incrustation, olive oil, a mild solution of baby shampoo and warm water or a special cleaning solution from the pharmacy can help with cleaning the edge of the lid.
Used cloths or masks must be cleaned thoroughly before further use. The hands must also be carefully washed and disinfected before and after this measure. An improvement in the symptoms often only occurs after three to four weeks when these hygiene measures are carried out on a daily basis. Everyday eye hygiene also helps prevent chronic blepharitis.
In general, traditional cosmetics and skin care products such as soap and creams with preservatives and irritants are not recommended. The face and eyes should only be cleaned with pure, warm water.
With careful and careful use, naturopathic treatment measures can have a healing effect, especially in the chronic forms of blepharitis. As with other eye infections, extracts from the medicinal plant eyebright (Euphrasia) are mainly used. The extracts of this plant contain antibacterial and anti-inflammatory substances. Most often it is used in the form of homeopathic eye drops. Eyebright tea can also be drunk for supportive, internal use.
In addition, compresses made from fennel tea or chamomile tea are used in naturopathy. However, a certain degree of caution is required here in order to avoid possible spreading of existing pathogens or, for example, not to have an adverse effect due to an allergic reaction.
Several studies have indicated that unsaturated fatty acids can have anti-inflammatory effects. If you pay attention to a healthy diet with sufficient polyunsaturated fatty acids (especially omega-3 fatty acids), this can help alleviate the symptoms of inflamed and dry eyes. (jvs, cs)
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Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dr. rer. nat. Corinna Schultheis
- Mayo Clinic: Blepharitis (accessed: July 8, 2019), mayoclinic.org
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- National Eye Institute (NEI): Facts About Blepharitis (accessed: July 8, 2019), nei.nih.gov
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- Professional association of ophthalmologists in Germany (BVA): inflammation of the eyelid (blepharitis) (available: July 8th, 2019), cms.augeninfo.de
- German Ophthalmological Society: Guide to inflammation of the eyelid margin (accessed: July 8, 2019), dog.org
- Mehrle, Georg: Ophthalmology: for nursing and health professions, Urban & Fischer Verlag / Elsevier GmbH, 8th edition, 2010
- Professional association of ophthalmologists in Germany: Guideline dry eye (Sicca syndrome) and blepharitis, as of March 2019, Augeninfo.de
ICD codes for this disease: H01ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.