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My husband was diagnosed with blepharitis. Will his eyelashes, currently facing down, go back up again on their own?
Blepharitis is inflammation of the eyelids. When it is acute (sudden and recent), warm compresses and oral antibiotics usually cure it, if it is infectious. It may be allergic, in which case antihistamines, cold compresses, oral steroids, or removal of the allergen may be advised.
Most blepharitis is chronic and often recurrent. Again, treatment is usually aimed at the cause. Many skin disorders (e.g., rosacea, seborrhea, etc.) are responsible. Demodex is an organism which can be the culprit. Low-grade staph infections can be present. Dry eyes, especially in older patients is often contributory.
Today we classify blepharitis as anterior or posterior, which gives clues to causation and management. Warm compresses, lid scrubs, oral tetracyclines, topical steroids, omega 3 oils, Azasite eyedrops and other treatments are used as necessary. Concurrent chalazia and styes should be treated. Meibomitis and/or meibomian gland dysfunction are important contributing factors which must be rigorously addressed.
Recently, the FDA approved a machine to treat the eyelids by heating the meibomian glands and squeezing out their secretions. The machine costs $100,000.00 and uses $700.00 worth of disposable components for each treatment. It is not covered by insurance. Look forward to some heavy marketing to attract patients to the practices who invest early in this technology!
Often, the lashes are misdirected when the disease is active, but this can often be corrected by appropriate management of the disease. If not, let him borrow your eyelash curler, or, better yet, get him his own!
Any comprehensive ophthalmologist can manage blepharitis, but if your husband is not responding to treatment, ask for a referral to a cornea/external disease specialist who has interest in this disease. Finally, make certain that he does not rub his eyes and realize that this is a chronic condition and there is no magic bullet.
Answered by: Richard G. Shugarman, MD
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