What we thought we knew

Blepharitis is an extremely common, chronic eyelid margin inflammation. It has been estimated to affect 5 million people in the UK alone. No age group is spared.

Symptoms include redness, flaking, crusts and eye discomfort ranging from mild to severe.

Sometimes the signs are obvious; sometimes the underlying disease is subtle, and the diagnosis can be overlooked as dry eye.

The eyelash areas developed crusting; the tear oil producing meibomian glands just behind develop inspissated turbid secretions. A spectrum of inflammatory surface disease can ensue.

The exact cause of blepharitis was never really understood. For over 3 decades staphylococcal bacteria or some kind of eyelid gland dysfunction were blamed. It was appreciated that there was an association with the equally mysterious facial skin condition of rosacea.

Treatment was challenging and barely controlled matters. Patients did their best with lid hygiene cleaning with cotton buds and baby shampoo. Occasionally, antibiotics were prescribed which suppressed the disease for a while, but for sure it would eventually come back.