Question: My eyes sting and water a lot. Also, when
I wake up in the morning, I have a lot of junk in my eyes. What’s
going on and what can I do?
Answer: You may have a mild case of blepharitis!
The term “blepharitis” may sound dangerous, but it is really nothing
to worry about. It simply means that you have eyelid (bleph) inflammation
(itis). Blepharitis is very common, and most of us have eyelid
inflammation to some degree, though certainly some people seem
to suffer more so than others. The hallmark symptoms of blepharitis
are stinging and a “gritty” sensation to the eyes.
To understand how your eyes are affected with blepharitis, there
are two things that occur along your eyelids. The first (and more
straightforward explanation) is that debris forms at the base
of the eyelashes. This buildup is composed of dry tear secretions
and dead skin cells, and this buildup can actually foster the
growth of skin bacteria that inflame the eyelids and cause discomfort.
This eyelash debris can even fall into your tears and irritate
the surface of the eye, making your eyes feel “gritty” or “sandy”
. . . especially first thing in the morning.
The second problem that blepharitis causes is a clogging of the
oil glands running along your inner eyelids (at the base of your
eyelashes). The oil produced in these glands is important because
it keeps your tears from evaporating too quickly. To explain this
phenomenon, you can imagine that the smooth surface of your eye
is like the driveway in front of your house, covered with a thin
layer of water (perhaps after a rain or after washing your car).
Because the water on your driveway is spread very thin, it evaporates
quickly. However, if your car has an oil leak, the oil doesn’t
evaporate off your driveway so fast … the oil is there for a very
long time!
The oil produced along your eyelid margins serves a similar purpose,
as this natural oil floats on the surface of your eyes and keeps
your thin tear film from evaporating away. With blepharitis, however,
the oil pores become clogged, and even though you seem to produce
copious tears, the actual quality of those tears is poor and they
tend to dissipate away. This causes further eye irritation!
There are several things you can do to treat blepharitis … both
to remove the debris along your eyelashes, and to allow your natural
oil glands to flow better. One simple method is to use a warm
compress, such as a washcloth run under warm water. Once a day,
lay this across your closed eyes to give yourself a little “eyelid
sauna.” The warm water will help open up those oil gland pores.
Some people find it helpful to add a dab of no-tears baby shampoo
and massage their lids in the shower (eyes closed, of course).
The combination of heat, a mild shampoo, and gentle massaging
will really get those pores to open up! This will also clear off
any debris that may be clinging to the base of your eyelashes.
Blepharitis is a chronic condition. It is not really an infection
or a disease, but more akin to having oily skin or dandruff. The
key is to come up with a regimen of lid hygiene that makes you
comfortable. If your eye irritation persists, you should consider
visiting an eye doctor. An eye doctor can look at your lashes
and meibomian (oil) glands under the microscope and give you a
more definitive diagnosis. Also, an eye doctor can prescribe a
short trial of oral antibiotics or topical antibiotic ointment
at night that helps many people suffering from blepharitis.
