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Features

Tired eyes just might have a medical cause

By TOM VALEO
Published June 27, 2006

If the eyes staring back at you from the mirror look puffy and bloodshot, or if they feel as though they're filled with grit, don't blame the ravages of age. You may have blepharitis blef-uh-RYE-tis.

Despite the unfamiliar name, blepharitis refers to a fairly common problem involving the eyelids.

With age, eyelids become more susceptible to inflammation. The most common cause of eyelid inflammation is bacterial or viral infection.

The inflammation may also be caused by allergies, exposure to smoke or fumes, or skin diseases such as seborrhea.

As a result, your eyelids may look swollen and red, and your eyelashes may look as if they have dandruff.

Blepharitis also may result from clogged meibomian glands on the inside of the eyelid. If that's the case, your eyelids will not secrete enough of the oily substance that helps lubricate your eyes and prevent your tears from evaporating. As a result, your eyes will feel dry and irritated.

Blepharitis tends to be a chronic condition, so your best bet is to keep it under control. But how?

First, you must know which type of the illness you have.

A bacterial or viral infection will produce crust along the eyelashes.

Allergic or seborrheic blepharitis will produce greasy scales and dandruff.

And if the tiny meibomian glands are clogged, you may find tiny pustules, like white pimples, on the inside of your eyelid.

For blepharitis caused by infection, "we emphasize cleanliness," said St. Petersburg ophthalmologist Frank I. Mendelblatt. "That means washing your hands and face. If some germ has gotten into your eyelids, we may treat that with antibiotic ointment or drops, and if the infection is really bad, we might prescribe oral antibiotics."

Applying a hot compress followed by a gentle eyelid scrub offers the best chance of getting blepharitis under control.

For the compress, saturate a washcloth with hot water and wring dry. Lay the compress over your eyes for a few minutes, which will soften and loosen any crust or scales along the eyelash line, making them easier to remove. Since bacteria can live in the crust and scales, washing them away will reduce the bacterial load and give your immune system a better shot at fighting off the intruders.

Also, if your meibomian glands are clogged, the heat will soften the secretions, making them easier to express.

Next, wash your eyelids with a soap that's not irritating - a mild, unscented soap, for example, or diluted baby shampoo.

And if you have clogged glands, a gentle massage will help remove the gunk. The Web site Aging Eye Times (www.agingeye.net), affiliated with the University of Illinois-Chicago, offers illustrated instructions on how to massage your eyelids. (On the home page click on "blepharitis.")

If the illness is caused by cosmetics, sunscreen or some other substance irritating to the skin, or if it's caused by allergies, you'll have to figure out what the offending substance is and then eliminate it.

"Cosmetics are frequently the cause," said Mendelblatt. "Sunscreens also irritate some people, as well as face powder, and preservatives in soaps or in medications.

"Or people can be allergic to the medication itself. People will say to me, 'but I've used it a long time; that can't be it.' But that's usually how it works - you use it for a long time and then you become sensitive to it."

The important thing is to figure out what is causing the eyelid inflammation and get the blepharitis under control, for the disease tends to be chronic. Even if you eliminate the problem, you will be more susceptible to recurrences.

--Tom Valeo is a freelancer who writes about medical and health issues. Write to him c/o Seniority, the St. Petersburg Times, P.O. Box 1121, St. Petersburg, FL 33731 or e-mail features@sptimes.com.

[Last modified June 27, 2006, 07:32:51]