One of my patients has red, swollen and itchy eyelids on both eyes. She complains of a gritty feeling and that her eyes stick together when she wakes in the morning. How can I help her?

This sounds like blepharitis. There are three types:

• Staphylococcal caused by bacteria which is found on the skin. In most people, this causes no harm but for some, it causes a localised infection.
• Seborrhoeic is linked to a skin condition where the skin is oilier than normal. Yeast in this oil causes an inflammatory response in some people.
• Meibomian is linked to the Meibomian glands just behind the eyelashes. They release oil which makes up the outer layer of the tear film. A problem with the glands and the oil leads to eyelid inflammation.

In most cases, blepharitis is uncomfortable but not serious or life-threatening. Complications are uncommon.

One treatment that is often recommended is to apply a children’s shampoo to the lid margins using a cotton bud applicator. This is not my preferred choice. Children’s shampoo is formulated for children’s hair and scalp not for eyelid margins and eyelashes.

I suggest applying mild warmth through a face cloth soaked in warm water for five minutes or better still a reusable heat bag that is warmed in a microwave and placed over the eyes for five minutes.

I also recommend cleaning and rubbing with an eyelid wipe that is formulated for the treatment of blepharitis.

This is a common condition which although rarely has serious eye complications can nevertheless have a large negative impact on quality-of-life through the way it makes the person feel and look. As such it should be taken seriously.