Bletharitis and Meibomian Cysts
Bletharitis is chronic condition of the eyelids. It causes dryness, itching and a gritty sensation in the eyes combined with crusting and greasiness of the eyelids.
The main cause is excess oil secretion from the meibomian glands in the eyelids. Sometimes little cysts form in the eyelids called meibomian cysts or chalazians. Small cysts often go away in a few months but large ones may need to be removed surgically. This is a minor procedure. However they can recur.
Treatment needs patience but bletharitis will eventually settle. The key is a regular hygiene routine.
A good approach is to wash along the line of the eyelids using a compress (warm water on a cloth or on cotton wool). Then run the finger over the lines of the lids with eyes closed going from the inner to the outer part of the eye. Then clean along the lid margins using a cotton bud dipped in a solution of sodium bicarbonate (1 teaspoonful in a cup of water which has been boiled and then cooled). Do this daily, increasing to four times daily if it flares up.
Other approaches involve using a weak solution of baby shampoo (diluted to 1 part in 10 in warm water) –put a drop on index finger and, with eyes closed, massage eyelids and eyelashes for half a minute before rinsing off. Another option is tea tree oil wipes. One study showed it was more effective than eyelid massage. Prescribable preparations such as Celluvisc or Viscotears used very regularly so as to moisten the eyes can also help. A commercial preparation called Lid Care is also available from chemists.
Ladies need to avoid solvent make-up removers. Removing make-up at night is crucial. Using hot compresses as for chalazions (see below) can also be helpful.
Deficiencies of some nutrients have been found in both humans and animals with bletharitis –these include deficiencies of zinc, vitamin B6, B2 and biotin so a multivitamin/multimineral may be useful. N Acetyl cysteine was also found to help in one study (take 100mg three times daily). The herb eyebright (available from health food shops) can be used as a compress. Put 15 grams of eyebright in 500mls of water. Boil and cool and use as a warm compress with a cloth or cotton wool.
As the glands secrete oil it is logical to make sure the body is producing the right quality of oils. This means enough essential fats and in the right ratio. Two studies have shown that using Omega 3 supplements can improve bletharitis (one used flaxseed and another study has shown omega 6 supplements) (see separate leaflet).
For meibomian cysts use a hot compress. This involves holding a hot flannel – ideally as hot as you can tolerate – gently over the closed eye. This warmth and slight pressure may be enough to cause the cyst to break down. Another option is to use a compress of castor oil which is an excellent softening and healing agent (soak a little into a cloth or flannel– warm it but don’t boil it first – and leave on for 45 minutes two or three times weekly –alternatively rub castor oil on the lids with a cotton bud twice daily. Health Food shops sometimes stock cold-pressed castor oil (see Castor Oil leaflet). In addition warm compress masks, which can be microwaved, are available over the internet and are said to work well. After using compresses, massage outwards along the lids to clear any cysts or blockages.