Blepharitis is a very common condition. It causes symptoms such as red eyelash bottoms and burning and stinging that disrupt patient comfort.

Inflammation of the base of the eyelashes is very difficult to treat. It is a chronic condition. Although it is not possible to cure it completely, it calms down with regular treatment and symptoms decrease. The area we call the base of the eyelash is the edge of the eyelid. In this area, the skin in front and the conjunctiva mucosa from behind meet. Eyelashes come out from here. There are also meibomian glands with pores in this area. The oil secreted by these glands lubricates the surface of the eye and slows the evaporation of tears. Inflammation of the base of the eyelashes is a common name for problems in this area. In addition, microscopic parasites called demodex that live in this area are the creatures that increase this inflammation.

There are several types of eyelash base inflammation. There are seborrheic form, which is characterized by dandruff and eyelash loss, and there are also types in which the meibomian glands located inside the eyelids do not work well, that is, the secretion of the oil layer of the tear is impaired. These conditions, which are referred to as inflammation of the root of the eyelashes, may give different symptoms. What they usually have in common is the prevention of adequate wetting of the surface of the eye and the occurrence of dry eye due to inflammation of the eyelashes.

What are the symptoms of eyelash base inflammation?
Symptoms of inflammation of the base of the eyelashes include burning due to dry eyes,

• Sting
• The feeling of sand escaping,
• Watering of eyes
• Eye redness,
• Eye tearing may include

In addition, pain in the eyes, swelling of the lids, fullness of the lids, redness, dandruff at the base of the eyelashes, itching at the base of the eyelashes, eyelash loss, whitening of the eyelashes can be counted due to inflammation of the eyelash base. Especially meibomian gland dysfunction, in which the meibomian glands do not work well, is the main cause of burning, stinging, watering and eye fatigue experienced by young people and computer workers.

The secretion of these glands is very important in terms of dry eye, because in the case of inflammation of the base of the eyelashes, the ends of these glands are blocked and when the secretions and secretions are not sufficient, the tear evaporates rapidly and the eye surface dries and also loses lubrication. Also, the lids that do not slide on the dry surface irritate the eye surface and increase the complaints of burning, stinging and watering. The comfort of our eyes depends on the adequate and proper secretion of the secretions of these glands on the eye surface. While the blockages at the ends of these glands simply increase the complaints of dry eye and cause burning, stinging and watering, fully blocked sebaceous glands cause stye, that is, chalazion.

If the ends of these glands, of which there are 20 in the lower lid and 40 in the upper lid, are blocked and destroyed over the years, very serious complaints of dry eye occur at an advanced age.

Eyelash base inflammation treatment?
In order for our eyes to be healthy and comfortable, it is necessary that the area around the base of the eyelashes is clean and healthy. Although the causes may be different, basically similar treatments are applied for all inflammations of the base of the eyelashes and meibomian gland problems. Although cortisone eye drops provide temporary relief, they have little place in the actual treatment, do not provide permanent treatment and have very serious side effects. The treatment of the inflammation of the base of the eyelashes is based on opening the meibomian gland mouths and cleaning the base of the eyelashes, in addition to controlling the demodex parasite, if any. To rid the base of the eyelashes of inflammation, they need to be cared for in the same way as we brush our teeth, because it is not possible to clean their tips very well when we wash our face. Here is what needs to be done to keep the meibomian glands working properly and to prevent inflammation of the base of the eyelashes.

They will be used for inflammation of the base of the eyelashes and meibomian gland dysfunction;

• Heat application – warming the lids and softening the oil secretion,
• Mechanical pressure – removing softened oils from the rag orifices by pressure,
• Mechanical cleaning – to remove dry oil plugs and dandruff,
• Chemical cleaning – to kill the demodex parasite,
• Lubricating the surface of the eye – tear drops.

First of all, in order for the secretions of the meibomian glands to reach the base of the eyelashes, their ends must be open, the oil secretion coming to this area dries up due to various metabolic and external influences and plugs are formed.

Prof. Dr. Ahmet Akman

Eye Health and Diseases Specialist

October 2023