Blepharitis Guide

7/27/2019 Blepharitis Guide

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How to Treat

Blepharitis & Eye AllergiesAnd Live Symptom Free

Published by Ten Doves Charity

Author: Dr. S. Banerji


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How to Treat Blepharitis and Eye Allergies -

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Dr. S. Banerji Page 2 TenDoves.org

About the Study

The purpose of this guide was to review numerous medical and scientific

studies, articles, journals, and surveys as well as certain non-medical, non-

scientific information about the subject of blepharitis and eye allergies

(our Research) and present an objective summary (Guide). This Guideprovides information about blepharitis and eye allergies based on our

Research and the consensus opinions of the professionals that contributed

to the Guide.

This Guide was authored by a doctor and provides comprehensive

information about blepharitis and eye allergies in easy to follow language

that is meant to supplementinformation from your doctor not replace it.Do not read this Guide unless you agree to the Terms & Conditions on the

Ten Doves website and below:

Terms & Conditions of use of the Guide: By downloading and opening this Guide, you (the

donor or recipient of the Guide) signify that you have read and agree to these Terms &Conditions of use of the Guide:

1. All information in the Guide is meant to supplement information from your doctor

not replace it. This Guide must not serve as a substitute for a professional medicalexamination, advice and treatment. Rather, it was written to help you understand

fundamental aspects of blepharitis and assist you in communicating with your doctor

to manage the condition optimally. Your doctors advice should always takeprecedence, and you must abide by his/her instructions and prescriptions even if

they contradict information contained therein.

2. You agree to indemnify and hold harmless Ten Doves and all related persons against

any damage, liability or expense arising from use of the information contained in the

Guide.

3. The Guide is the intelletual property of Ten Doves - all rights reserved. It is provided

to you for personal use only and shall not to be copied, re-sold, or re-distributed to

anyone else.

4. Any legal claim must be filed within one year of your first download of the Guide,shall be governed by binding arbitration, and filed in Collin County Texas only.

5. If you do not agree to these terms do not read the Guide - send an email [email protected] for a refund.


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Table of Contents

Chapters Page

Introduction............................................................................................................................. 4

Chapter 1 Diagnosis ......................................................................................................... 6

Chapter 2 Posterior Blepharitis .................................................................................... 9

Chapter 3 Anterior Blepharitis ................................................................................... 13

Chapter 4 Other Related Conditions ........................................................................ 15

Chapter 5 Eye Allergies................................................................................................. 16Chapter 6 Treatment ..................................................................................................... 18

Chapter 7 Prevention of Reoccurrences ................................................................. 30

Conclusion .............................................................................................................................. 32

About the Author ................................................................................................................. 33

About the Publisher ............................................................................................................ 33


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Introduction

The term blepharitis refers to various types of inflammation and infection

affecting the eyelids, eyelid margins, eye lashes, and meibomian glands.

Blepharitis is a common eye disorder throughout the world. It is more

common in 3rd world countries but it is found everywhere. It can occur

with children but more typically affects adults. Causes include working orliving in a dirty environment and poor hygiene, but it doesnt necessarily

have to. That is because few people are aware of the importance of eyelid

hygiene. Often the first time they hear the terms blepharitis and eyelidhygiene is from an eye doctor that has diagnosed the condition.

There are numerous symptoms (below) and causes (illustrated on the

right) that overlap.

Symptoms of blepharitis include:

Itching and/or burning of

the eyes Redness of the eyes and

eyelids Flaking of skin on the lids Foamy or frothy discharge

from the eyes Crusting at the lid margins (particularly after waking in the morning) Foreign Object Sensation in the eyes Dry eye sensation in the eyes Reduced vision Sensitivity to light (oncoming headlights at night) Plugged or partially plugged meibomian glands Blephospasms Loss of eye lashes

Excess tearing

Infection

AllergyIrritants


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Unfortunately, blepharitis is typically a chronic condition that has no cure,

but it can be managed with long-term eyelid hygiene and medicine.

Blepharitis is not contagious and when properly treated does not usuallycause permanent eye damage.

Blepharitis is often classified into two types:

Posterior Blepharitis (affecting the insides of the eyelids and lidglands)

Anterior Blepharitis (affecting the outsides of the eyelids and eye

lashes)

This Guide explains how blepharitis is diagnosed and each type in detail. It

also explains treatment options, homeopathic and herbal remedies, and

prevention of re-occurrences. It also describes eye allergies that can oftenaccompany, contribute to, or create similar symptoms of blepharitis.


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Chapter 1 Diagnosis

Professional Diagnosis

Do you know the difference between an optometrist and an

ophthalmologist? When most people think of eye doctors they think ofoptometrists. An optometrist is a health care professional who is licensed

to provide primary eye care services for vision correction including eye

glasses and contact lenses. They also examine and diagnose eye diseasessuch as glaucoma, cataracts, and retinal diseases and other problems. An

optometrist will recognize the symptoms of blepharitis, however, one

should be referred to or seek out an ophthalmologist for treatment of thiscondition.

An ophthalmologist is an eye M.D., a medical doctor who is specializes in

eye and vision care. Ophthalmologists are trained to provide the fullspectrum of eye care, from prescribing glasses and contact lenses to

complex and delicate eye surgery. They may also be involved in eye

research. After 4 years of medical school and at least one year of

internship, each ophthalmologist spends a minimum of 3 years of residency

(hospital-based training) in ophthalmology. During residency, the eye M.D.receives special training in all aspects of eye care, including prevention,

diagnosis and medical and surgical treatment of eye conditions anddiseases. An ophthalmologist may spend additional time training in a

subspecialty of a specific area of eye care as well.

Based on their education and training, ophthalmologists are universally

cited throughout the Research as the best medical professional to diagnose

and treat blepharitis. Ophthalmologists can be located in your area from

referrals from optometrists, the Yellow Book, and from the Internet.

Your appointment with an ophthalmologist will include a full eye

examination including a check of vision acuity, color, stereopsis, near pointof convergence, pupils, visual field screening, pressure and other tests.


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The eye doctor will examine the health of the eye and eyelids using a slit

lamp biomicroscope and fluorescein staining. This microscope has an

attached light that allows the doctor to examine the eye under highmagnification to examine the cornea, iris, lens, and eyelid structure. He or

she may also press on the eyelids to detect blocked eyelid glands and an

oozing of oil indicating clogged meibomian glands. There is no single

specific test for blepharitis, but if you have it, the ophthalmologist will beable to diagnose it. If anterior blepharitis is suspected, the doctor may

order a lab culture test.

An illustration a normal eye versus one with blepharitis is below:

Notice the white bumps at the eyelid margin representing plugged glands.

Also notice how the inflammation is causing the eye to appear red and

inflamed.

Blepharitis is generally classified into the following types and sub-types:

Posterior Blepharitis (affecting the insides of the eyelids and lid

glands)o Meibomian Gland Dysfunction (MGD)

o Mixed (MGD mixed with anterior Blepharitis)

Anterior Blepharitis (affecting the outsides of the eyelids and eyelashes)

o Staphylococcal

o Seborrheic

o Mixed (with each other and/or posterior Blepharitis)


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MGD involves the posterior eyelid margin (inside the eyelids by the base of

the eyelashes). Seborrheic and staphylococcal Blepharitis involve mainlythe anterior eyelids (outside the eyelids and at the base of the eye lashes).

There is considerable overlap of symptoms of all types of Blepharitis. It

also frequently leads to associated ocular surface inflammation, including

conjunctivitis, functional tear deficiency, and keratitis.

Blepharitis symptoms are almost always bilateral and symmetric meaning

it occurs in both eyes equally or near equally. Symptoms in one eye only

may indicate a different and possibly more serious condition.

Patients reported in the Research that extended periods of computer use,

TV watching, or reading, contributed to their condition. This may be afunction of less blinking while doing these activities, as the eye lashes weredesigned to help screen out particulates before entering the eyelids.

People suffering from allergies also reported higher percentages of the

Blepharitis condition.

Blepharitis can have onset at any age, but is most frequently firstexperienced by middle-aged adults. In two studies, patients with MGD and

seborrheic Blepharitis were generally older and had a longer history of

symptoms (range 6 to 11 years). Patients with staphylococcal Blepharitis

had mean ages of 43 and a relatively short history of symptoms (2 years).

The following chapters describe each type of Blepharitis in detail.


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Chapter 2 Posterior Blepharitis

Meibomian Gland Dysfunction (MGD)

The conditions that lead to MGD include a build-up of dirt, oil, and dead

skin around the eyes over a period of time. This provides a breeding

ground for bacteria that blocks the eyelid glands ultimately causing thiscondition. Most people are not taught about eyelid hygiene until it is too

late. Even people with excellent hygiene might not know that they have tomake extra daily cleaning efforts around the eye sockets, eye lids, eyebrows, bridge of the nose and entire facial area.

Without regular proper eyelid hygiene is it fairly easy, and in fact quite

common, to get MGD. Living or working in dirty areas enables this

condition as does certain drug use and allergens. Chronic cases have beenlinked to environmental factors such as chemical fumes, smoke, and smog.

Some people with particularly dry facial skin are prone to this condition

since a build-up of dry dead skin around the eyes contributes to this

condition. Improving your environment by reducing allergens will help. Afew examples include washing pillow cases and bed sheets daily, using andchanging indoor air quality filters, and getting allergy tests (further

discussed in Chapter 5).

The eyelids have oil secreting glands at the eyelid margin called meibomianor tarsal glands. The naturally produced oil mixes with tear drops to cover

the eyeball reducing friction between the eyeball and the back of the

eyelids. The oil keeps the teardrops from evaporating too quickly. Normaleye drops containing the proper amount of oils will remain on your eyeballbetween 10 and 15 seconds before breaking up and evaporating. Without

the oil, natural tears will break up and evaporate in less than 10 seconds.

Ironically, some patients believe that they are suffering from a dry-eye

condition when in fact they have MGD. That is because when themeibomian glands are plugged, producing less than normal oils, the tear


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glands actually produce more tears than normal in an attempt to

compensate, but without sufficient oils these tears evaporate too quickly.

Your eyes and eyelids are complex the anatomy is illustrated below.


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Look for the meibomian (tarsal) glands in the above illustration they are

small delicate passages inside the eyelid (posterior), under the eyelashes,

which can clog easily. They are illustrated in blue because a normallyfunctioning gland will secrete oils from the bottom and middle of the gland

out through the small opening when you blink.

When you pull your lower eyelid down with your finger, the meibomianglands open at the very edge between the inner and outer eyelid. If you

look with a 10X magnification eye-makup mirror, you can see the small

openings and the whitish glands that run up the inside of the eyelids

towards the openings at the end.

Clogged, inflamed or blocked eyelid glands reduce the amount of natural

oils available to mix with tear drops to lubricate the eye. When thishappens, friction is created causing discomfort and small flakes of skin canrub off of the back of the eyelids further clogging the eyelid margins. If

untreated, this will add to the build-up of bacterial growth that inflames the

eyelids and affects its appearance and texture.

Plugged meibomian glands have a yellow or white cap of crustation overthe gland. A picture of these caps appears below from RootAtlas.com, and

the link to this video from Youtube.com is also below.


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http://www.youtube.com/watch?v=p4l6NwxKSGo&feature=related(if link does not work, search youtube.com for meibomian glands)

Notice that the doctors finger is pressing downwards on the lower eyelid

margin exposing the tops of the meibomian glands. You can clearly see

the white pustules on top of each gland. A normally functioning glandwould not be plugged or capped. If the cap were soft enough, the doctor

could press on the gland removing the cap and expressing the built-up

fluids in the gland. When the gland is infected with bacteria the expressedfluids will appear milky or yellow in color instead of the normal clear color.


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Chapter 3 Anterior Blepharitis

Staphylcoccal Blepharitis

Staphlycoccal Blepharitis is caused by infection of the anterior portion of

the eyelid (outside of the eyelids at the base of the eyelashes) bystaphylococcal bacteria. As the infection progresses, the sufferer may

notice inflammation, a foreign body sensation in the eyes, loss or matting

of the lashes, and stinging. The condition can sometimes lead to a moreserious chalazion or stye.

This condition is diagnosed based on the patient's medical history and abacterial culture. Middle-aged women appear in the Research to be more

susceptible to this condition than men.

The presence of a ring-like formation around the eye-lash shaft can be

observed by the doctor using a slit-lamp microscope. This is the primarysign of this condition. Other specific symptoms include loss of eye-lashes,

matting, or broken eyelashes.

If left untreated, this infection may spread to other parts of the eye or tothe scarring of the cornea. This condition may or may not be accompanied

by MGD or seborrheic Blepharitis.

Seborrheic Blepharitis

People with seborrheic Blepharitis typically have soft greasy scales and eyelashes along the length of the eyelid margin. Eye-lashes tend to clump and

stick together. Sufferers tend to be older and it affects men and women

equally.

Certain skin conditions such as eczema, dermatitis, seborrhea, and

dandruff can contribute to seborrheic Blepharitis. Most people exhibit one


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Chapter 4 Other Related Conditions

Occular Rosacea

This condition is characterized by erythema (redness) of the cheeks, nose

and/or forehead. Pustules may be found along the eyelid margin and theremay be infection of the cornea. If untreated, it can lead to lid scarring and

eyelid misdirection.

Occular Rosacea is more common in women but is usually more severe in

men.

Psthiriasis Palpebrarum

This condition is an infestation of the eye-lashes by crab lice. The lice

attached to the base of the eyelids and lay eggs that appear as small white

or brown pearls.


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Chapter 5 Eye Allergies

Eye Allergies

The conjunctiva of the eyelids are some of the most sensitive tissues on

our body. For many people, the environment causes allergic reactions that

can accompany or mimic symptoms of Blepharitis such as red eyes,itching, watering, foreign body sensation and many others.

For chronic Blepharitis sufferers we recommend a thorough examination by

a qualified allergist physician. In addition to a visual check, they will likelyorder a full spectrum allergy test. This test is done by two methods:

Scratch Test This test involves drawing a checker-board across

your back creating 80 or more squares. The technician then applies80 different allergens, one drop at a time in each square. The

allergens are samples of things that typically cause allergic reactions

such as grasses, pollen, dust, animal hair, etc. The technician then

uses a sharp sterile instrument to scratch the skin below each dropwith sufficient depth to cause the fluid to permeate the outer layers

of the skin. During a 30 minute observation period, the technicianand doctor will notice and record your bodys reaction to each

allergen ranking each from 0 5, with 5 being the biggest reaction.

Blood Test Blood is drawn and sent to a laboratory for further

allergic testing. Often this is done to verify certain results from the

scratch test or to test something that wasnt included in the panel.

For example, if a person owns a particular type of animal or breed ofanimal, a blood test can verify how allergic they are to that specific

animal.


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Eye Allergies Contributing to or Mimicking Blepharitis?

It is important to determine whether a patient has Blepharitis without eyeallergies, Blepharitis with eye allergies, or eye allergies that are mimicking

the Blepharitis condition. I make this distinction because the treatments

are different. For example, the typical first line of defense for Blepharitis is

an eyelid hygiene program including eye-lid scrubs. While effective for

Blepharitis, it could make eye allergies worse.

Ask your ophthalmologist if he or she thinks that eye allergies could becontributing to your condition, and then see an allergist. Once diagnosed,

treatments by allergists usually involve changing things in yourenvironment, diet, and getting immunology shots. This is explained in the

next chapter.


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Chapter 6 Treatment

Treatment Regimen for Blepharitis

Performing immediate eyelid hygiene is the first step to recovery from both

posterior and anterior blepharitis. This is accomplished with a series of at-

home treatments explained below.

Use a warm moist terry washcloth applied to the eyelids to loosencrusted secretions.

o Hold the warm wet cloth over your eyes for 5 minutes, 3 timesa day. The temperature should be shower warm to hot but

not scalding hot. The heat, moisture, and pressure will loosen

and remove the scales, oil, grime and other impediments at the

base of the eyelashes.

o Next rub the washcloth horizontally across the outside of the

eyelids, back and forth, about ten times. Your eye-lid marginsare very delicate so do not rub too hard, just enough so youcan lightly feel the cloth to remove loose particles and grime.

Once you have completed one eye, flip the cloth over and use

the other side for the second eye. Try opening your eyes

slightly while you are rubbing them so the terry cloth fibers cancleanse the eyelid margin at the base of the eyelashes. Theterry cloth has a sufficiently fibrous texture to scrub away theunhealthy materials, but be sure to rub the eyelids only and

not the eye surface itself.

o For additional cleansing you can try adding diluted babyshampoo to the washcloth. Many peoples eyes are sensitive to

baby shampoo, however, and if you have a negative reaction

discontinue its use; it can be helpful but is not necessary.


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o As the final step, take a cotton swab and gently press the tip

against the outside of the eyelids near the very end, pressing

up towards where the Meibomian glands exit at the margin (a10X magnification makeup mirror is helpful). You are gently

messaging the glands by pushing up and through the outside of

the eyelids, not the inside. It should only take about 30

seconds to do the lower and upper lids, and then, gently pullthe end of a new swab laterally across the tops of the margin

lids removing any materials that were expressed through the

tops of the glands. It is important that you do these

techniques gently.

Some people get better results using special eyelid cleanser instead

of, or in addition to, the terry cloths. They come in individuallypacked pads with cleaning solution, and cleaning foams. Onepopular brand is called OCuSOFT which comes in an original formula

and a Plus formulation enhanced to help eliminate bacteria.

Sometimes the doctor prescribes a specially formulated eyelid

cleanser to clear the lash area of crusts and scaling. OCuSOFTs line

of eyelid hygiene products appears below, and most of theseproducts can be found at your local pharmacy.

www.ocusoft.com/products


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For seborrheic blepharitis caused by certain skin conditions such

eczema, dermatitis, seborrhea, and dandruff, certain over-the-

counter or doctor prescribed medicines are used to treat these

conditions. This may include using a dandruff shampoo such as Head

and Shoulders. T-Gel (both in regular and extra strength formula)and T-Gel conditioner are stronger solutions effective in treating

these conditions and are excellent when alternated with Head andShoulders.

If lice are the cause of the symptoms, petroleum jelly can be applied

along the base of the eyelashes to eliminate them, or one can obtain

over-the-counter or doctor prescribed ointments.

Prescriptions

For stubborn cases, eye doctors typically prescribe a more aggressive

regimen using prescription medicines, in addition to the eyelid hygienetechniques above. These include:

STERIOD DROPS: Steroid eye drops may be used to treat

inflammation and help eliminate foreign materials. These are

typically prescribed over a 3 - 4 week period, 4 drops per day. If youare taking steroid drops, it is important to strictly adhere to your eyedoctors orders. During this period the eye-doctor will perform tests

to check the pressure in your eyes. Prolonged use may cause

increased pressure in the eyeball with certain patients, which could

lead to cataracts, glaucoma or other problems. Ophthalmologistshave dozens of prescription medications at their disposal to treat

blepharitis, and several of the more commonly prescribed medicines

reported in the Research are highlighted below:

o FML (fluorometholone ophthalmic suspension, USP 0.1%) FML, produced by Allergan, contains the active ingredient

fluorometholone. It is a type of medicine called a corticosteroid

(or steroid) used as a topical anti-inflammatory agent forophthalmic use. This type of steroid should not be confused


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with anabolic steroids that have gained notoriety due to their

abuse by some athletes. Corticosteroids are hormones

produced naturally by our bodies (by the adrenal glands) thathave many important functions including control of

inflammatory responses. They work by acting within cells to

decrease the release of inflammatory substances thereby

reducing swelling, redness and irritation. Use only asprescribed side effects are listed on the manufacturers

packaging.

o Pred Forte (Prednisolone) Pred Forte, preduced by Allergan,is another type of corticosteroid containing the active

ingredient prednisolone. Prednisolone is a synthetic

corticosteroid that can be administered into the eyes todecrease local inflammation caused by blepharitis. It is alsosometimes prescribed after eye surgery. Use only as

prescribed side effects are listed on the manufacturers

packaging.

o Zylet (loteprednol etabonate 0.5% and tobramycin 0.3%ophthalmic suspension) Zylet eye drops, produced by Bausch

& Lomb, is a sterile, multiple dose topical anti-inflammatory. It

is used to treat inflammation caused by surgery, infection,

allergies, and blepharitis. Use only as prescribed side effectsare listed on the manufacturers packaging.

o Alrex (loteprednol etabonate) - Alrex, produced by Bausch &

Lomb is a corticosteroid prescription eye drop used for thetreatment of seasonal eye allergies (allergic conjunctivitis and

others). It has been shown to be effective for treating a widerange of eye allergy symptoms and for sufferers of blepharitis.

Use only as prescribed side effects are listed on the

manufacturers packaging.

There are numerous other prescription eye drops used for thetreatment of blepharitis as well. Since each patient may react

differently to the various active and inactive ingredients in each, theeye doctor may utilize a trial-and-error process to determine which

prescription medicine is optimal for a specific patient.


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General Precautions for using steroid drops:

o If these products are used for 10 days or longer, intraocularpressure should be monitored by your doctor.

o These products are sterile when packaged. To prevent

contamination, care should be taken to avoid touching the

bottle tip to eyelids or to any other surface. Keep bottle tightlyclosed when not in use, do not share with others, and keep out

of the reach of children.

o Wait at least 15 minutes before inserting contact lenses.

o Consult your doctor if you are pregnant or nursing.o Discontinue use if you suffer adverse reactions and consult with

your doctor.

o Read and follow the instructions on the manufacturerspackaging.

CORTICOSTERIOD OINTMENTS: Corticosteroid ointments are often

prescribed in conjunction with eye drops. These special antibiotic

eye ointments usually contain erythromycin or bacitracin. The

ointment is applied before bed each night and last longer than drops.This will reduce bacteria on the eyelid margins overnight.

ORAL ANTIBIOTICS: A round of oral antibiotics is usually also

prescribed. This is used to treat any bacteria build-up that mighthave contributed to the blepharitis condition. In the Research,

doxycyline and tetracycline are the most often cited prescription

antibiotics for treating blepharitis. They tend to dry the oil build up

in the eyelid glands, in addition to treating the underlying bacteria.Oral antibiotics are often prescribed for a 60 120 day period which

must be taken for the entire prescribed length of time, or riskrelapse.

ALLERGY, DRY EYE AND LUBRICANT DROPS Prescription and non-prescription allergy, dry eye, and lubricant drops are often prescribed

in combination with, or after, steroid drops, depending upon thepatient and symptoms for treatment of blepharitis and other

conditions such as conjunctivitis and dry eye. There are numeroussuch eye drops with various active and inactive ingredients (different

patients can different reactions to active andinactive ingredients).


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Such eye drops include Pataday, Zyrtec, Refresh, Optive,

Restasis and many other types and brands.

The above treatment regimen must be performed under the close

supervision of an eye doctor. During your treatment you will have follow

up check-ups to confirm how well you are responding to the hygiene and

prescription treatment, and changes might be made.

Most patient testimonials in the Research reported much improved

comfort and vision within the first four weeks of their eye doctors

treatment, and near normal or normal condition after eight weeks of

treatment.


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Eye Allergy Treatment

Once an allergist diagnoses a patient with eye allergies he or she willrecommend a treatment plan based upon the patients medical and family

history, medical condition, examination, and the results of the allergy

tests. The treatment plan could include the following:

ENVIRONMENT: You must become aware of the environment aroundyou in your home, in your car, at your work, and in public places.

There are numerous publications available from doctors, bookstores

and online on how to improve allergies. Below is a summary:

o Home Environment: Upgrade your home HVAC filters and change them on a

regularly schedule basis every 30 or 90 days dependingupon the type.

Have a professional HVAC cleaning performed annually. Purchase several mobile air filtration devices place one

next to your bed, near pets, in the kitchen, and in areas

that you spend time in.

Purchase dust mite covers for your bed and pillowcases.

Clean sheets and pillowcases daily with hot water anddetergent.

Use anti-allergen cleaning solutions. Use anti-allergen shampoo, conditioner, soap & lotions.

Use anti-allergen shampoo for pets. Replace carpeting for wood or tile flooring.

Keep doors and windows closed to keep out airborne

pollen, grasses and pollutants (important for eyes).

o Car Environment: Many cars have cabin air filters (change regularly). Clean cabin with anti-allergen cleaners. Keep windows closed while driving to keep out airborne


o Work Environment: Purchase a mobile air filtration unit.

Use anti-allergen cleaning solutions for your desk and

work area.


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Keep windows closed while driving to keep out airborne


If you work outside, use wrap-around sunglasses.o Public Places:

Avoid smoke filled rooms people are not usually allergic

to smoke but it is a major irritant.

When outside, use wrap-around sunglasses.

Immunotherapy: The allergist may prescribe allergy shots to boost

your immune system. The theory is to bombard your system with

low doses of the irritants that your body is most allergic to. Overtime, the bodys defenses create increased internal immunities to

these irritants resulting in less severe reactions when you come into

contact to them in the future.o Their office or lab concocts a set of serums containing 5 50ml

for a series of shots.

o Shots are given in the arm starting with a low dose, twice perweek.

o Shots are increased in strength until reaching the highest level.o Maintenance shot is given once per month.

Eye Allergy Drops: Pharmaceutical and homeopathic companies havedeveloped a series of eye allergy drops. You may wish to discuss

these products with your eye doctor, and based on his or herrecommendation, conduct some trials. Some contain blood vesselconstrictors which many eye doctors do not recommend, so be sure

to be through in your investigation and doctor discussions about the

suitability of these products for you.


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Surgical Options for MGD

For the most severe cases of MGD, eye doctors may offer certain patientsrelatively new surgical options to open blocked meibomian glands. One

such surgical tool and technique is Fugo blade surgery. The Fugo blade is

a nanotechnology incising device employing plasma. The plasma allows for

bloodless or near-bloodless surgery and ablating small vessels and

capillaries. Fugo plasma ablation has a documented surgical history ofsafety with thousands of cases to date.

Our view at this time is that virtually all of the millions of patients that

suffer from the blepharitis and MGD conditions can achieve good results

from the treatments described earlier in the Guide. In our opinion,patients should exhaust every other possible option before consideringsurgery, and then, only under the guidance of a qualified doctor with direct

experience.

A photo of the Fugo blade tip appears on the next page along with a link to

a video from Youtube.com posted by Dr. Daljit Singh, DSC, MS, Amritsar,

India, demonstrating the Fugo blade procedure treating MGD.


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http://www.youtube.com/watch?v=V99HBOHiR3E(if link does not work, search youtube.com on meibomian glands and Fugo Plasma)

As you can see from the video, Dr. Singh has anesthetized the patients

eyes, eye sockets, and eyelids. He then used the sterile Fugo plasma

blade to penetrate the top of each blocked meibomian gland, eliminating

blockages and unhealthy material. Pent-up oils are expressed through thetop of each gland.

After the procedure, patients took antibiotics to control infections. Patientsin the Research reported immediate results, but were required to maintain

long-term eyelid hygiene.


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Some references to patients in the Research suggested the benefits

appeared that they would be permanent or near permanent while others

reported that the MGD condition returned within 6 18 months after theprocedure. To our knowledge, since this is a relatively new procedure and

the long-term benefits have yet to be studied and reported.

Of course, like any surgical procedure, the Fugo plasma blade proceduremust only be performed only by a trained eye doctor familiar with this tool

and procedure, in a jurisdiction that has medically approved this

technology for this use.


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Chapter 7 Prevention of Reoccurrences

While there is no cure for blepharitis, most patient testimonials in the

Research reported much improved comfort and vision within the first four

weeks of their eye doctors treatment, and near normal or normal

condition after eight weeks of treatment.

Once treated, the chances of reoccurrence of the symptoms of blepharitisare mostly up to you. Living a symptom free life is mostly a factor of

maintaining a consistent and disciplined eyelid hygiene program, a healthydiet and living environment, limiting exposure to allergens and building

immunities, and managing stress.

Consistency

Consistency of treatment is the key to managing blepharitis and living

symptom free.

Sticking to every bit of your eye doctors treatment plan is very important.

If you are given prescriptions for eye drops, ointments, and/or antibiotics it

is CRITICAL that you finish the fully prescribed amounts. A common

mistake that people make is to begin to feel better and then reduce or stopthe treatments. Dont make this mistake. If you do, the bacteria and

other contributors to the condition can come back with a stronger

resistance to the medicines.

While modern medicine has no final and complete cure for blepharitis, you

can be optimistic that you can control the impact that this problem has onyour life and lifestyle. With proper treatment and preventive maintenanceyou can greatly minimize any problems and discomfort.


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Daily Routine

Blepharitis can become very frustrating for people that have chronic cases.You must stick to the complete treatment regimen that your eye doctor

prescribes andadd this eyelid hygiene regimen to your daily routine just

like brushing your teeth.

Overall good health, diet, sleep, building up your immunities, and

managing stress are also important.


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Conclusion

The term blepharitis refers to various types of inflammation and infection

affecting the eyelids, eyelid margins, eyelashes, and meibomian glands.

Blepharitis is a common eye disorder throughout the world. Causes can

include working or living in a dirty environment and poor hygiene, but it

doesnt necessarily have to. That is because few people are aware of the

importance of eyelid hygiene and dont learn about it until it is too late.

Symptoms of blepharitis include itching and/or burning of the eyes,

redness of the eyes and eyelids, flaking of skin on the lids, crusting at the

lid margins (particularly after waking up in the morning), a foreign object

sensation in the eyes, and greasy clumping or loss of eye lashes. Eyeallergies often contribute to, or mimic, the blepharitis condition.

This Guide describes how blepharitis and eye allergies are diagnosed, and

each type in detail. It also explained treatment options, homeopathic andherbal remedies, and prevention of re-occurrences.

While there is no cure for blepharitis, one can control the impact of this

problem with proper treatment and continued long-term preventive

maintenance and live symptom free.


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About the Author

This Guide was authored by Dr. S. Banerji, CBAM, PGDM, MSc, BSc. Dr.

Banerji is a practicing clinical biophysicist in Mumbai, India. He is also anactive researcher and writer of medical articles and guides distributedworldwide. Illustrations were drawn by Ms. M. Perrine. Ms. Perrine has anAssociate degree in Fine Arts and Pre-allied Health. She specializes in

medical drawings, illustrations, charts and artwork. Any references to any

other trade names or intellectual property belong to their respectiveowners.

About the Publisher

This Guide is published by Ten Doves, a 501(c)(3) non-profit organization

that helps children in need and provides research information. All funds

from the sale of this Guide go to Ten Doves Vision Fund. To learn moreabout Ten Doves please visit its website located at www.tendoves.org.

Ten Doves Charity

5100 W. Eldorado Pkwy. #102-732Mckinney, TX 75070

Phone: 469-217-1000

Email: [email protected]

How to Treat Blepharitis and Eye Allergies 2nd Edition Copyright 2011

(1st Edition Copyright 2006)

Ten Doves, a non-profit organization All Rights Reserved

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Blepharitis Guide