 |
 |
|
|
|
|
DESCRIPTION
Blepharitis is an inflammation of the outer edges of the eyelids that causes redness, itching, burning, and, often, a sensation of having something in one's eye. Other possible symptoms include swelling of the eyelids, loss of eyelashes, excessive tearing, and sensitivity to light. Secretions may form crusts that "glue" the eyes together during sleep.
This condition is caused by an infection of the eyelash follicles or glands at the outer edges of the eyelids. Eyestrain, poor hygiene, poor living and sleeping habits, poor nutrition, and systemic disease with resulting immunodepression commonly contribute to the problem. Blepharitis, may also be associated with seborrhea of the face or scalp.
There are 3 forms of blepharitis (staphylococcal, seborrheic, and MGD). All three forms of blepharitis are chronic in nature. People with staphylococcal blepharitis are relatively young (average age 42 years) with a short history of ocular symptoms (average about 1.8 years). People with seborrheic blepharitis and MGD blepharitis are generally older and have a longer history of ocular symptoms.
In staphylococcal blepharitis there is scaling and crusting along the eye lashes. In seborrheic blepharitis there is greasy scaling along the eyelashes. Patients frequently have seborrheic dermatitis as well. In Meibomian gland dysfunction (MGD) there are prominent blood vessels crossing the eyelid margin. In addition there is pouting or plugging of meibomian gland openings, and poor expressibility and/or turbidity of the oily meibomian secretions. Patients with MGD frequently are noted to have coexisting rosacea and seborrheic dermatitis. Use of isotretinoin (Accutane), an oral medication for severe cystic acne, has also been implicated as a cause of blepharitis.
TREATMENT
Blepharitis is a chronic disease for which there is no cure, and requires long-term treatment to keep it under control. Treatment consists of 2 phases (Acute phase and Maintenance phase). Acute phase treatment involves intensive therapy to rapidly bring the disease under control. In the maintenance phase the goal is to indefinitely continue the minimum amount of therapy that is necessary to keep the disease quiet. Herein we will not focus on the treatment of specific steroid responsive complications of blepharitis like marginal ulcers and phlyctenules, as they are less common and require specific diagnosis. We will focus on the treatments that help control the blepharitis process itself. Needless to say, controlling blepharitis itself, will reduce all the other blepharitis related complications.
Warm Compresses followed by Lid Scrubs is the most critical element of effective blepharitis control. This therapy removes the eyelid debris (which can be colonized by bacteria), reduces the bacterial load (mechanically as well as by lysis of bacteria due to detergent action of the soap in lid scrubbing) and stabilizes the tear film by releasing oily secretions from the meibomian glands, thus reducing tear evaporation (so the dry eye symptoms are also reduced).
See Seborrhea for more information about this disorder.
MEDICAL & HOLISTIC RECOMMENDATIONS & NUTRITION
WARM COMPRESSES
Warm compresses heat the debris and crust on the lid margin to or above the melting point of their individual components so that they are easily removed with the lid scrubs.
Technique: Soaking a washcloth in water as warm as the eyelids can stand, and then placing the cloth on the lid surface (eyelids closed) for a five to ten minute period. In the acute phase this is performed 2 to 4 times day.
We have read about variations/innovations in the way warmth may be applied to the eye. One method described is the use of a fresh-boiled egg (in its shell wrapped in a washcloth). Another method described is to use a stocking filled with grains of uncooked dry rice heated in a microwave oven to a comfortable warm temperature.
Warm compresses may be combined with eyelid massage. This is especially important in people who have Meibomian gland dysfunction (MGD). An analogy here will clarify the issue. In MGD the meibomian secretions are turbid and the gland openings are clogged. Think of a toothpaste tube which has butter (instead of toothpaste). When cold, you will not be able to express the butter out of the tube. However, once you heat it, then the butter will soften enough to come out of the tube, but pressure on the tube (squeezing) would still be necessary. Going by this analogy, after warm compresses, the turbid meibomian gland secretions are more fluid, but massage is necessary to express them. Therefore after every 1 minute of warm compresses, massaging the eyelid as follows will be useful:
- Gently close the eyelids. Put your index finger on the outer corner of the eyelid. Pull the eyelid towards the ear, so that the eyelids are stretched taut.
- Next use the index finger of the opposite hand to apply direct pressure to the taut eyelids starting at the inner aspect of the eyelid near the base of the nose.
- Sweep with firm but gentle pressure towards the ear. Repeat this maneuver four to five times. Remember that the goal is to apply gentle pressure to the eyelids - so just rubbing the eyelid surface will do you no good.
LID SCRUBS
There are several ways of performing lid scrubbing. You can choose whichever one you are most comfortable with. The scrubbing should be directed at the base of the eyelashes on the eyelid margin. Soaps (cleansing agent used) should not have excessive perfume or lotion content.
Neutrogena Bar Soap: This bar soap is used to form lather on the clean finger tips. Lather is then applied with fingertips on the eyelid margin and eyelash bases for up to 1 minute (with eyelids gently closed so that soap does not enter the eye). This is followed by a facial rinse.
Johnson's Baby Shampoo: The baby shampoo is first diluted one-to-one with water in a "cup" in the palm of the hand. This is then mixed by rubbing with the clean fingertips and then applied in a gentle oval scrubbing motion to the margin and eyelash bases of the closed eyelid for 1 minute, followed by a fresh water facial rinse.
The soap solution (bar soap or baby shampoo) can alternatively be diluted in a container (e.g. plastic cup) and scrubbing performed using a washcloth wrapped around a finger (after dipping it in the diluted soap solution. A cotton tip applicator may be used alternatively.
There are commercially available cleansing pads that are pre-soaked in a cleansing solution (OcuSoft Lid Scrubs or Novartis Eye-Scrub). These cleansing pads are equally effective albeit more expensive method of lid scrubbing and are claimed to be less irritating to the eyelids. One study showed then to be preferred choice by people as compared to other methods of lid scrubbing.
ANTIBIOTIC TREATMENT
The use of an ointment on the eyelid margin immediately after lid scrubbing may help to increase comfort. The choice here is usually Erythromycin eye ointment or Tobradex eye ointment (steroid-antibiotic combination). In addition, the antibiotics help to further reduce the bacterial load on the eyelids.
Oral tetracyclines (doxycycline or minocycline) for about 3 months can be used in recalcitrant Meibomian Gland Dysfunction (MGD) cases. Tetracycline antibiotics affect the meibomian gland secretions, inhibit bacterial lipases as well as reduce the eyelid bacterial load.
ANTI-INFLAMMATORY TREATMENT
Castor oil has been used traditionally in folk medicine as an anti-inflammatory remedy for treatment of blepharitis. The main ingredient in Castor oil is ricinoleic acid. Castor oil could either increase or decrease eyelid inflammation depending upon whether it is used only once or is used several times for many days. Eyelid inflammation may increase initially after starting treatment but with repeated use over a week, the blepharitis inflammation will be reduced. Refresh Endura tears is a Castor oil emulsion. Restasis eyedrops has Castor oil in addition to cyclosporine. Increasing the intake of Omega-3 fatty acids (flaxseed oil supplements) may also reduce the blepharitis inflammation.
ANTIOXIDANT TREATMENT
Eating more grapes may help blepharitis sufferers. The formation of oxidants like nitric oxide in the involved eyelid margin have been speculated to play a role in blepharitis. The substance, known as resveratrol is an anti-oxidant that is very effective against these nitrite type of oxidants. Grapes are particularly good sources of resveratrol. Resveratrol is found in the skin (not flesh) of grapes. Fresh grape skin contains about 50 to 100 micrograms of resveratrol per gram and red wine (also rich in resveratrol) contains about 1.5 to 3 milligrams per liter.
HerbalRemedies: Resveratrol Synergeistic Formula, Nature's Way, 37.5 mg, 60 Caps
Japanese knotweed is a potent source of Resveratrol and has been used for the heart, liver and blood vessels.
N-acetylcysteine (NAC), is an amino acid that enhances the production of glutathione, one of the body's most powerful antioxidant enzymes. In one reported study the effect of 100 mg of N-acetylcysteine orally, three times each day for 8 weeks. This treatment resulted in stabilization of tear film and reduced discomfort of blepharitis. Oral N-acetylcysteine treatment for blepharitis needs further evaluation. N-acetylcysteine is a supplement, therefore is available over the counter or in health food stores without prescription. There are several NAC brands (Twinlabs, Solgar, Now Foods, Puritan's Pride). It is essential that you consult your health care provider prior to initiating any treatment.
HerbalRemedies: NAC (N-Acetyl-Cysteine), NOW Foods, 600 mg, 100 Caps
Protein synthesis is one of the most vital functions taking place in each and every human body. In order for us to utilize our protein intake in an efficient manner, an ample supply of the amino acid glutathione must be present in our cells. NAC (N-Acetyl Cysteine) is essential in the formation of glutathione, as it directly impacts our ability to synthesize the proteins we ingest. NOW NAC (with added trace elements of molybdenum and selenium) acts as a precursor to the production of glutathione, helps ward off infections through its antioxidant/detoxification properties and facilitates the production of several digestive enzymes.
HERBS
Warm Eyebright, Goldenseal, or Mullein compresses are soothing and help reduce inflammation. Prepare a tea using one of these herbs, cool it to a comfortably warm temperature, and soak a clean cloth or a piece of sterile cotton in it to make the compress. Apply the compress and relax for 10 to 15 minutes. Then make a fresh compress and gently wipe the edge of the eyelid and the area among the eyelashes to remove any scaly matter or dandruff-like debris. Do this twice a day or as needed. Use each compress only once before laundering or discarding it.
RECOMMENDATIONS
Eat a well-balanced diet that emphasizes fresh, raw vegetables, plus grains, legumes, and fresh fruits.
Keep the eyelids clean, especially along the edges (see herbs above), but do not touch or rub your eyes except when necessary. Always wash your hands before touching your eyes.
Get sufficient sleep, and avoid eyestrain. Anything that increases eye fatigue makes the discomfort worse.
NUTRITIONAL SUPPLEMENTS
Unless otherwise specified, the dosages recommended here are for adults. For a child between the ages of 12 and 17, reduce the dose to 3/4 the recommended amount. For a child between 6 and 12 years of age, use 1/2 the recommended dosage, and for a child under the age of 6, use 1/4 the recommended amount.
NUTRIENTS Supplement Suggested Dosage Comments Infla-Zyme Forte
From American BiologicsAs directed on label. Aids in reducing inflammation. Vitamin A 25,000 IU daily. If you are pregnant, do not exceed 10,000 IU daily. Important in all eye disorders.
Vitamin A, 10,000 IU, 100% Natural, Nature's Way, 100 SoftgelsPlus
Natural Beta-Carotene
Or
Carotenoid Complex (Betatene)As directed on label.
As directed on label.Important antioxidants and precursor of vitamin A.
Beta Carotene (Natural Dunaliella Salina), Nature's Way, 100% Natural, 25,000 IU, 100 Softgels,
Multi-Carotene Antioxidant, Nature's Way, 60 SoftgelsVitamin C
With
Bioflavonoids6,000 mg daily, in divided doses. A powerful antioxidant that protects the eyes and reduces inflammation.
Vitamin C Liquid w/ Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, Dynamic Health, 1000 mg, 16 fl. oz.,
Ester C With Bioflavonoids, Nature's Way, 1000 mg, 90 Tabs,
Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 Vcaps,
The Right C, Nature's Way, 1000 mg, 120 TabsZinc 50 mg daily. Do not exceed a total of 100 mg daily from all supplements. Needed for proper immune function. Use zinc gluconate lozenges or OptiZinc for best absorption.
Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz.,
Ionic Zinc, Trace Minerals, 50 mg, 2 fl. oz.,
Colloidal Silver & Zinc Lozenges, SilvaSolution, 90 Lozenges
TYPES OF EYE PROBLEMS & DISORDERS
Maintaining Healthy Eyes
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or a family member are having problems with vision and/or you suspect an infection.
You have any increase of symptoms.
You have any unexpected or unusual symptoms. There may be underlying health issues that need to be addressed.
You should have your eyesight checked regularly by your health care provider to rule out any problems and to receive a prescription for contacts or eyeglasses, if they are needed. Preserve you vision... it is very important.
HELPFUL RELATED LINKS
MoonDragon's Health & Wellness: Nutrition Basics Index
For a full list of available products from Mountain Rose Herbs, click on banner below:
HELPFUL PRODUCTS & FURTHER EDUCATION
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 2nd Edition
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 4th Edition
Prescription for Herbal Healing: The A-To-Z Reference To Common Disorders
-- by Phyllis A. Balch
The Complete Guide to Natural Healing
This is only a small sample of educational materials and products available through Amazon.com. Use the search box provided below to search for a particular item.
HERBS, OILS, & SUPPLIES
Mountain Rose Bulk Herbs
Mountain Rose Aromatherapy Oils
Click Here To Visit Herbal Remedies Product Page
A Source For Medicinal & Ritual Herbs & Supplies
Aphrodisiacs Aromatherapy Bath & Body Care Bulk Herbs By The Pound Capsules, Tablets & Extracts Chinese Herbals Electronics Extracts First Aid Products Food Products, Mixes, Seeds, Snacks & More! Hair Care Products & Supplies Herbs & Oils, Kilo & Ton Hydroponics & Gardening Kava Products Kitchen & Housewares Mushrooms Musical Instruments Oral Care & Dental Products PC & IT - Computer Supplies & Assessories Skin Care, Cosmetics, & Gift Sets Smokes, Seeds, Cacti Spices, Salts, Sweeteners, & Seasonings Sports, Toys & Games Sweets, Candy, Chips & Snacks Stimulants Sedatives Teas & Coffees
Shaman Shop Home Page
