Blepharitis

Q) For the past few months, I’ve been suffering from dry, red eyes and flaky eyelids, which my eye doctor has diagnosed as blepharitis. I’ve been prescribed an ointment, but I’d rather try natural remedies first. What do you suggest? —J.G., via e-mail

A) Blepharitis, or inflammation of the eyelids, is a chronic condition that can lead to redness, dryness, burning, itching and irritation of the eyes. The most common causes are poor eyelid hygiene, bacterial infection and excess oil production by the meibomian glands in the eyelid. Identifying the cause is key in any healing plan (see
box below).
Conventional treatment usually involves keeping the eyelids clean, applying warm compresses, using anti-dandruff shampoo and, when necessary, antibiotics or steroid eye drops. However, these measures tend to ease symptoms rather than cure. What’s more, medicated eye drops can cause serious side-effects, such as increased pressure in the eye, and changes to the lens and cornea (Can J Ophthalmol, 2008; 43: 170–9).
Happily, dietary changes and nutritional supple-ments can be effective alternative treatments.

Nutritional therapies
- Essential fatty acids. Supplements of both omega-6 and omega-3 fatty acids may help against blepharitis. In 57 patients with meibomian gland dysfunction (a common form of blepharitis), warm compresses, eyelid massage and eyelid margin scrubbing, combined with a daily dose of omega-6 (28.5 mg of linoleic acid and 15 mg of gamma-linolenic acid), reduced symptoms better than either treatment alone (Cornea, 2007; 26: 260–4).
Omega-3 supplements (two 1000-mg capsules three times a day) led to significant improvement in blepharitis sufferers after one year of treatment (Trans Am Ophthalmol Soc, 2008; 106: 336–56).
- N-Acetylcysteine (NAC). This amino acid appears to help prevent dry eyes. In 40 patients with chronic blepharitis, the addition of oral NAC (100 mg three times daily) to their conventional therapy (topical antibiotics and steroids, and artificial tears) significantly increased tear quantity and improved tear quality, compared with the conventional therapy alone (Cornea, 2002; 21: 164–8).
- Vitamin A. The daily use of eye drops containing vitamin A (Viva-Drops; Vision Pharmaceuticals) led to the complete resolution of chronic blepharitis that had failed to respond to topical antibiotics and steroids—albeit in a single case study (Altern Med Rev, 2008; 13: 191–204).
- Other nutrients. Deficiencies of vitamin B6, biotin, riboflavin and zinc have each been reported to result in blepharitis in humans and animals. Multivitamin and mineral supplements containing these nutrients are therefore recommended as supportive treatment in cases of blepharitis (Altern Med Rev, 2008; 13: 191–204).

Other solutions
- Homeopathy. There is a range of homeopathic remedies for eye infection and inflammation, including Sulphur, Natrum Muriaticum, Hepar Sulphuris Calcareum and Mercurius Solubilis.
However, it’s best to let a qualified homoeopath make a diagnosis, and choose the best remedy for your constitution and symptoms.
- Honey. Honey—especially good-quality manuka honey, which has a wide range of antibacterial activity—can be used topically to treat bacterial eye infections (J Med Food, 2004; 7: 210–22). In 102 patients with eye infections, including blepharitis, improve-ment was seen in 85 per cent of cases (Bull Islam Med, 1982; 2: 422–5).
 Apply the honey to the eyelid (but not the eye) as you would an ointment.
- Herbs. Calendula (marigold), chamomile, eyebright and comfrey have traditionally been used for eye inflammation. For rapid relief of redness and swelling, try a compress of eyebright [15 g of dried herb in
500 mL (16 oz) of water, boiled for 10 minutes]. Make sure that the preparation is sterile by making a fresh brew every time and throwing away the excess.
- Hygiene. Any treatment for blepharitis should always be combined with a strict eyelid cleaning routine. Clear away oil and debris from around the eyelash follicles by applying warm compresses (using a cloth or cotton wool warmed with hot water) to the eyelids several times a day. Immediately after this, moisten a cottonbud with a solution of warm water and sodium bicarbonate (1 tsp in a cup of water will do), and use it to gently clean along the eyelashes.
Avoid touching the eye itself and always use water that’s been freshly boiled, then cooled.

What causes blepharitis?
- Avoid eye irritants. Wearing contact lenses and eye makeup can make blepharitis worse.
- Bacterial, fungal or viral infection
- Meibomian gland dysfunction
- Skin conditions such as rosacea
- Allergies
- Parasites such as Demodex folliculorum.

 

Vol 20 03