Some years ago, I visited a friend of mine who was working as an optometrist in a community private practice in the Caribbean. Although I didn’t examine any patients as I wasn’t licensed to work there but I remember him telling me that many of the patients he saw complained of burning eyes. Their eyes always looked quiet and healthy. The best he could come up with was blepharitis. The lid margins looked reasonable but when he advised lid hygiene and artificial tear drops for most patients the symptom of burning eyes disappeared.
Thinking back now it was probably seborrheic blepharitis. This is linked to a skin condition where the skin is oilier than normal. Yeast in this oil causes an inflammatory response in some people, which can affect the Meibomian glands while leaving very little redness at the lid margin. The oils necessary for a stable tear film don’t work efficiently and this leads to a short break-up time, which in turn can cause the eyes to have a burning sensation.
He advised his patients to apply mild warmth through a face cloth soaked in warm water for five minutes or better still a reusable heat bag that can be warmed in a microwave and placed over the eyes for five minutes.
He also recommended cleaning and rubbing with an eyelid wipe that is formulated for the treatment of blepharitis.
The artificial tear drops help reduce the discomfort especially if they are applied from the fridge.
Blepharitis is a common chronic 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. It can however be difficult to identify and as it’s chronic, treatment needs to continue for the long term. When treatment is stopped symptoms are very likely to return. It should always be taken seriously.