Blepharitis – A common childhood condition

BY PENDA HONEYGHAN

Wednesday, October 31, 2018

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IT is unlikely that their eyesight will be affected, but in the case of paediatrics patients diagnosed with blepharitis, paediatrician Dr Anona Griffith said that the common condition can be a source of pain and discomfort for the child.

“Blepharitis is long-standing inflammation of the lining of the eyelids. While the condition affects people of every age group, it is quite common in children and often recurs several times over the course of childhood, and often triggers a secondary infection which is characterised by loss of eyelashes,” Dr Griffith said.

She explained that the eyelid can be divided into two regions — an anterior or front portion and a posterior or “back” portion. The posterior part, Dr Griffith pointed out, has specialised sweat glands called Meibomian Glands which produce a thin film of oil that keeps a thin layer of tears in the eye. Both of these Griffith said are necessary for maintaining the moisture of the eye and is protective.

“In Blepharitis both areas can be affected. The inflammation may involve the glands themselves or the areas without glands, which is usually at the base of the eyelashes toward the front of the eye. Once there is blockage of the glands, the quality and quantity of tears are also disrupted, leading to dryness, or in some cases excess production of tears and risk of infection described as Meibomian Gland dysfunction,” Dr Griffith underscored.

She said that children who have skin conditions such as eczema or seborrheic dermatitis are also at an increased risk for Blepharitis. Other triggers of the condition include irritants such as cleansers used to wash the face, and chemicals in products such as wipes, as well as dust.

While the condition may present with different symptoms in children, Dr Griffith said that among the telltale signs are:

• Greasy, sometimes reddened eyes and eyelids

•Swelling of the lids

•Crust-like flakes resembling dandruff that form at the bottom of the eyelashes

•Occasional loss of eyelashes and scarring of the eyelids

•Itchy, burning eyes

•Dryness of the eyes; grainy feeling in the eye

•Excessive tear production

•It may also affect your vision — blurring and sensitivity to light.

Dr Griffith said once your child presents with these symptoms you want to have them investigated. She said that in treating the condition, there are a number of medical as well as non-medical options that you should explore.

“Deciding on the treatment method will be dependent on a number of factors, including age, history, symptoms, as well as the severity of the condition. There are a number of things that you will also want to consider to practise long term in order to reduce the possibility of the problem resurfacing,” Dr Griffith advised.

You may need to:

•Practise good hygiene — number one is always to wash your hands well.

•Avoidance — avoid contact with irritants as best as you possibly can.

•Try to keep hands away from eyes — this can be particularly difficult in the case of babies and small children, but try to manage your child's contact between their fingers and eyes where possible. Since this can be difficult to try to ensure that their hands are always clean.

•Clean eyes — practise cleaning eyes with mild cleansers (for example tear-free baby shampoo) as may be recommended or saline solution.

•Try soothing agents — apply a warm compress multiple times a day; this should help with soothing discomfort.

•Massage lids

• Apply artificial tears.

While most cases are identified and addressed early, there are severe cases that will require pharmaceutical treatment.

“Medication has a limited but important role and is generally used in very severe cases. Topical steroids in the form of drops under the careful guidance of a physician are often prescribed and antibiotics may also be prescribed where there is an infection,” Dr Griffith advised.

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