Inflammation of the Eyelid

Blepharitis or inflammation of the eyelid is one of the most common long term disorder of the eyes, affecting the edge of the eyelids and the eyelash hair follicles. It is inflammation of the eyelids and results in eye discomfort, redness, burning, itching, light sensitivity, sandy, gritty or foreign body sensation that is usually worse on awakening.

Understanding the cause and background will help explain why some alternative treatments used by doctors are effective.

Note: More information on the science of the solution to inflammation of the eyelid at the bottom.

Using a simple logic of controlling blepharitis, it may be possible to reduce the blepharitis related complications.

There are two forms and three kinds of blepharitis, all three being chronic or long term.

Blepharitis can be anterior or posterior. Anterior blepharitis affects the area of the eyelashes, caused by bacterial infection or seborrheic dermatitis. Posterior blepharitis is the MGD form found below. Like the anterior form, it may accompany seborrheic dermatitis.

Staphylococcal Blepharitis (affects those in their early 40s with brief history of eye problems).

This results in scaling and crusting along eyelashes.

Seborrheic Blepharitis (Generally older patients with longer history of eye problems).

Often results in a greasy scaling along eyelashes and seborrheic dermatitis may be present.

MGD Blepharitis or Meibomian gland become unable to secrete due to the damage caused by inflammation. (Generally older patients with longer history of eye problems)

Notable blood vessels cross the eyelid margins. There is a problem for the glands that secrete meibomian secretions. Rosacea and seborrheic dermatitis may be present. Accutane is associated with causing blepharitis, a negative side effect.

One theory holds that the changes may be the result of oxidative damage of some of the essential molecules produced in the meibomian glands called phosphatidylethanolamine and sphingomyelin. These help the oily layer of tear film maintain its structural integrity. Once these molecules are broken down or become defective as a result of oxidation, the protection of the tear film is lost, resulting in increased tear evaporation, dryness and irritation of the eyes.

Treatments for Blepharitis

Studies using oral supplementation with NAC or N-acetylcysteine have been found to be helpful those suffering with chronic posterior blepharitis (Cornea (2002;21:164?8). The study involved 40 patients suffering with chronic posterior blepharitis.

They were divided into groups to receive either a standard therapy alone (control group). The standard therapy included topical steroids, antibiotics, warm compresses to the eye lids 2 times a day and the use of artificial tears.

The test group were taking 100 mg three times per day for eight weeks.

The conclusion was that, although this is preliminary, NAC could provide relief from this difficult to treat condition. NAC is a precursor of glutathione, a natural intercellular antioxidant. Supplementation with NAC or whey protein isolate, the bioactive form of cysteine, has been shown to increase glutathione levels in various tissues of the body. It is felt that the tear film is normalized because of the antioxidant properties of glutathione.

Note that many of the suggested alternative treatments below also include co-factors of glutathione.

There still needs to be more research to determine the benefits and long term outcomes of this recurring condition.

Alternative Therapies for Inflammation of the Eyelid or Blepharitis

There are numerous treatments that have been suggested and tried as an alternative treatment for blepharitis or eyelid inflammation.

In addition to the two forms of cysteine, there are other things that can help. All are oral or dietary considerations. All have in common the anti-inflammatory benefit effect.

• Omega-3 fatty acids (flaxseed oil supplements)
• Grapes and the resveratrol found in them.
• Barberry
• Bayberry
• Beta-carotene
• Bilberry
• Calendula
• Chamomile
• Citrus Bioflavonoids
• Dandelion
• Evening Primrose Oil
• Eyebright
• Fish Oil
• Goldenseal
• Lutein
• Passionflower
• Red Clover
• Selenium
• Vitamin A
• Vitamin B complex (A combination of B Vitamins, Pantothenic Acid , Biotin , Folate , Inositol , and Choline
• Vitamin C
• Vitamin E
• Zinc

Note that there are no high level studies to show that these are helpful.

There are herbal preparations that some use. Having seen the bad side effects of home remedies, these will not be listed here. They should only be used, if at all, under the supervision of a licensed health care practitioner who is trained and experienced in their use. They are potentially dangerous to your eye health and eye sight.

More recently in Optometry, 2009, Oct;80(10):555-66 in the article (https://www.ncbi.nlm.nih.gov/pubmed/19801339?)...Advancements in anti-inflammatory therapy for dry eye syndrome...reviewed the current research on inflammation of the eye lid.

The study found that inflammation was responsible in perpetuating and sustaining dry eye.

The anti-inflammatory medications helped patients with moderate to severe dry eye when compared as compared to alternative treatment modalities of inflammation of the eyelid.

Based on the evidence, one of the most effective medication given is also available over the counter. It is N-Acetylcysteine (NAC). Since it works to make mucous thinner and promotes free-flowing, NAC helps in treating lipid-associated eye conditions.

There are numerous research reports affirming that using N-Acetylcysteine is more effective than artificial tears to promote significant improvement in the symptoms associated with blepharitis. In the above studies, simply using NAC, blepharitis symptoms were reduced as tear film quality improved. This was using only 100mg of NAC three times a day.

Since NAC has a 12 hour half life, similar results could probably be realized by just taking the NAC early in the AM and between noon and 3PM to resolve inflammation of the eyelid.

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