We often associate itchy irritated eyes to allergies or dust in the environment, but did you know that the source of your itchy irritated eyes might actually be coming from your eyelids? We often forget that our body is a host to many different micro-organisms. Some of these relationships are symbiotic, such as our bacterial intestinal flora that help us digest certain types of foods. However, there are times when there are micro-organisms that can become parasitic and are not beneficial to us as the host.
Blepharitis is a common term for an inflammation of the eyelid. This inflammation typically occurs from bacteria such as Staphyloccus. With the development of these bacterial infections of the eyelid, exotoxins from the bacteria can be secreted into the eyes causing itchy red irritated eyes that can be mistaken for allergic reactions. Bacterial related eyelid infections are often times easily removed with a simple cleaning regimen of hot compresses and lid massages using Johnson and Johnson baby shampoo. In more severe cases, antibiotic ointments are prescribed to address the minor infections. In cases where the blepharitis does not resolve despite treatment we have to look at other micro-organisms that may actually be causing the inflammation of the eyelid.
Demodex folliculorum and Demodex Brevis are two common parasitic mites that are found on the skin and hair follicles around the face. These mites bury themselves in the hair follicles of the eyelashes, eyebrows and face and can cause severe irritations. The mites have elongated bodies with eight short legs. They can travel up to 8-16mm per hour on the surface of the skin. Often times, patients will be asymptomatic, but in immunocompromised situations, the population of these mites can explode. Diagnosis often times requires removal of a few lashes and close examination under a microscope where the mites can be observed.
Presence of demodex can be a very difficult condition to completely eliminate as the mites bury themselves into the base of the follicle. Treatment of demodex does not currently have a pharmaceutical option in the US, relying on using natural remedies such as tea tree oil and a few other medicated wipe options. Treatment should not be initiated without evaluation by an eye doctor as over the counter tea tree oil may be caustic to the eye.
New developments of in office procedures using tools such as the Bleph Ex lid hygiene cleanser can be used in conjunction with home therapy to remove significant debris on the surface of the eyelid margins. Food sources can be targeted with in office thermal treatments to help remove excess oils and potentially damage the lifecycles of the dust mites preventing reproduction.
The condition is a complex disease that is currently being treated aggressively with new developments in technology, but is a chronic and difficult condition to remove completely. Often times, the goals of treatment are to minimize long term damage to the oil glands of the eyelids, prevent lid lash loss and decrease symptoms of discomfort such as itching, burning and redness.