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While we talk a lot about dry eye disease, blepharitis, and meibomian gland dysfunction (MGD), a term you may not have heard of is blepharoconjunctivitis. As you may be able to guess, this condition isn’t all that different from the other conditions we cover in depth, but it’s an important one to cover since many of you are experiencing this very thing.
Blepharoconjunctivitis occurs when the normal bacteria on the eyelids overpopulate and cause not only irritation and inflammation of the eyelids, but the eyeball as well. Since the conjunctiva is the clear outer covering over the white, front part of the eyeball (the sclera), the conjunctiva is what becomes inflamed quite easily in this condition.
Conjunctivitis is simply inflammation of the conjunctiva, and you should be able to see how easily this can occur. Bacteria are normally present on our skin, and we see
staph bacteria present in the highest quantities. This is a natural part of being human, but it can become overpopulated. When this occurs, inflammation develops as bacteria produce biofilm and toxins. When this occurs on the eyelids, blepharitis occurs. Many times, blepharitis is not treated properly or is hard to contain, and it can spill over to cause inflammation of the conjunctiva. This is blepharoconjunctivitis.
Most commonly, those with blepharoconjunctivitis will also suffer from some form of seborrhea, which is a common skin problem. Those that have issues with their sebaceous glands may also find themselves in this situation because the meibomian glands are sebaceous glands. Acne rosacea is also a common trigger for blepharoconjunctivitis, and all of those already mentioned will contribute to either anterior or posterior blepharitis. Anterior blepharitis is what you’ll usually know as blepharitis, and this affects the front portion of the eyelids and the eyelashes. Posterior blepharitis, on the other hand, causes issues with the meibomian glands (and is also called MGD). In summary, the following conditions may all contribute to blepharoconjunctivitis:
Although bacterial conditions are not contagious as we know viral conditions to be, it’s still so important to practice proper hygiene. Make sure you wash your hands before touching your face for any reason. Some studies have shown that we touch our faces up to 23 times per hour! If you’re going throughout your day rubbing your eyes, you’re only going to increase the chances of spreading and overpopulating bacteria.
It’s truly amazing and frightening the number of people who do not remove their makeup before they go to sleep at night. Not only are you allowing chemical-filled makeup to sit on your face all night, but you’re inviting bacteria to colonize and reproduce at lightning speed. Make sure you’re thoroughly removing all makeup. We recommend an oil based eye makeup remover because these do a great job at dissolving all makeup (even the waterproof kind). If you’re interested in learning more about the chemicals to avoid in makeup, check out this article.
Because demodex eyelash mites can greatly contribute to blepharoconjunctivitis, it’s important to use a tea tree oil product to combat this. Studies have shown that tea tree essential oil has the ability to kill demodex, and we recommend using a tea tree face wash each night.
When bacteria begin to overpopulate, they begin to form biofilm. This substance acts like a protective fortress around bacteria, and it is very hard to penetrate with eyelid cleansing alone. BlephEx done in your doctor’s office every few months, or the NuLids device used at home, can penetrate biofilm and help your eyelids heal more quickly. Click here to read more about biofilm and what you can do about it.
If you find symptom relief from warm compresses, you should continue these daily. Warm compresses can help hardened, stagnant oil become more liquid. This will allow this essential oil to flow out into the tear film where it belongs. For those with ocular rosacea, it can be difficult to use them and they may make symptoms worse, so only use them if you feel they are helping you.
After you’ve completed all of the above, cleanse your eyelids with hypochlorous acid. We recommend hypochlorous acid because it is naturally made by the body to fight microorganisms. It is produced to help you, and it just happens to be incredibly gentle on the eyes and eyelids. Simply spray your closed eyelids with the solution, rub it in, and let it dry. There’s no need to rinse it off!
The majority of you reading this are eating inflammatory foods for breakfast. Sugary cereal, bacon, sausage, cheese, dairy yogurt, pancakes, and the like can all be very inflammatory. They’re not adding many nutrients and antioxidants into your system. When you replace these foods with a green smoothie, you flood your body with hydration, antioxidants and nutrients first thing in the morning. Your body needs all of this to function optimally, and you start off on the right foot by having a green smoothie.
Once you have all of the above in place, many of you will still notice symptoms. It’s important to see your doctor when you first notice symptoms of blepharoconjunctivitis so they can help you accelerate an anti-inflammatory plan. Many of the things they recommend may be mentioned above, but they are also able to prescribe medications that may be helpful for you.
The number one cause of blepharitis is staph bacteria, especially Staphylococcus aureus. Another common cause is scalp dandruff. Although these are the two main causes, there may be many other contributors including demodex eyelash mites, medications, and others.
The best treatment is prevention. Just like you brush your teeth every single day, twice per day, it’s important to clean your eyelids every single day. By brushing your teeth, you maintain optimal oral health and stave off cavities and other issues. The same is true for eyelid cleansing. When you ensure eyelid hygiene, you help prevent blepharitis and MGD in the first place, or prevent it from becoming more severe. We recommend using a hypochlorous acid eyelid cleanser because this solution is gentle and a natural complement to your body’s own healing capacity.
This condition occurs when the lateral (temporal) portion of the eyeball and eyelids are inflamed. You may notice redness, flaking, and overall discomfort in that area. This form of blepharoconjunctivitis is usually caused by either Moraxella or Staph, both bacteria commonly found on the skin and in the body.
Blepharitis is a chronic condition that has no cure. It may never go away completely, but you can rest assured that it can be properly managed. Flare-ups of blepharitis may occur for many reasons, including environment, weather, lack of hygiene or a slack in eyelid hygiene, poor diet, stress, hormone fluctuations, and other factors. As you can see, many things play into blepharitis and may contribute to this condition, so it’s important to manage all of these factors.
To your naked eye, blepharitis may look like redness of the eyelid margins and flaking or crusting of the eyelids and lashes. You may also notice red eyes. Your eye doctor will be able to visualize blepharitis more thoroughly, and they may notice redness of the eyes and eyelids, flaking and crusting of the eyelids and eyelashes, dry patches on the cornea, meibomian glands that are atrophied or shortened, and a lack of proper tear production (especially oil production). Not all those who suffer from blepharitis will have these signs and symptoms, and it will depend on the form of blepharitis you have (anterior vs. posterior).
Prevention is key, and you can do this first through eyelid hygiene. Ensure that you’re removing all makeup at the end of the day and wash your face (we recommend a tea tree oil soap). After this, consider using the NuLids device to remove biofilm. Utilize warm compresses to heat the oils within the meibomian glands and loosen the crusts on the eyelashes. After these steps, we recommend using hypochlorous acid to cleanse your eyelids. You can find our recommended eyelid hygiene routine here.
There is no cure for blepharitis because it is a chronic condition. However, there are many ways to effectively manage this condition. Follow a daily eyelid hygiene routine and look for ways to be healthier overall in your life. Remove processed foods and instead choose more plants (fruits, vegetables, and whole foods) to keep you full and satisfied. Also work on drinking more water and managing your stress levels, which can both have a huge impact on chronic disease in general.
Blepharitis is not contagious. This condition is caused by bacteria, for the most part, and while bacteria can be spread it is not necessarily contagious. If you know you have blepharitis, follow all of the eyelid hygiene recommendations. By removing your makeup thoroughly, washing your face, and eyelid cleansing, you can ensure you’re doing a lot towards preventing this condition from becoming more severe.
References:
https://www.ncbi.nlm.nih.gov/pubmed/6233233
http://www.med.umich.edu/1libr/Ophthalmology/comprehensive/Blepharoconjunctivitis.pdf
https://www.reviewofophthalmology.com/article/when-blepharoconjunctivitis-refuses-to-go-away
https://www.ncbi.nlm.nih.gov/pubmed/25637115