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Blepharitis in Babies: Symptoms, Causes, Treatment And Prevention

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Blepharitis is an inflammation of the eyelids, usually at the base of the eyelashes. It is not a contagious disease unless caused by pathogens. The condition is usually uncommon in infants, but when it occurs, it can cause symptoms like swollen eyelids and crust around the eyelashes.

Seek medical attention if your baby develops blepharitis as it may lead to severe infection and recurrence, without proper care.

In this post, we tell you about the types of blepharitis in infants, causes, symptoms, and treatment of the condition.

Different Types Of Blepharitis

Blepharitis is classified into two types (1).

  • Anterior blepharitis: Inflammation of the area where the eyelashes are attached. It is on the outer front edge of the eyelid. It is usually caused by bacteria such as staphylococcus and seborrheic or dandruff.
  • Posterior blepharitis: Inflammation of the inner edge of the eyelid where it touches the eyeball. It occurs mostly due to the dysfunction of the meibomian gland (an oil gland).

What Causes Blepharitis In Babies and Toddlers?

The following factors can cause blepharitis (2).

  • Bacterial infection (staphylococcus bacteria)
  • Fungal infection
  • Acne rosacea (skin condition with redness on the face)
  • Parasite such as Demodex (tiny mites in the eyelashes)
  • Seborrheic dermatitis (dandruff on scalp and eyelids)
  • Abnormal oil production and secretion from the meibomian glands of the eyelid
  • Allergic reactions to skincare products or medicines

Signs And Symptoms Of Blepharitis In Babies

Signs and symptoms may vary depending on the cause. You may notice that your baby is rubbing eyes more than usual. Below are the other symptoms and signs of the condition (3).

  • Redness on the eyelids
  • Thick and yellow scales stuck to the eyelids; scales may resemble dandruff
  • Eyelashes appear crusted after waking up from sleep
  • Fluid leaking from the eyelids
  • Swollen eyelids
  • Sensitivity to light (photophobia)
  • Frothy tears
  • Dry eye
  • Misdirected eyelashes
  • Loss of eyelashes
  • More frequent blinking

Your baby might be crankier than usual due to the irritation of the eye. You should also look for skin rashes or other signs that might indicate the baby is ill.

When To See A Doctor?

See a doctor promptly on observing any of the following signs (4).

  • Increased redness or swelling of the eye
  • Pus or blood draining from the eyelid
  • Crying and trying to itch the eye
  • Fever
  • Worsening of any symptom

Who Are At Risk For Blepharitis?

Blepharitis can be usually seen in a baby with (5):

  • Seborrheic dermatitis or scalp dandruff
  • Dry eye (not enough tears in the eyes)
  • Any abnormalities of the meibomian glands

How Is Blepharitis Diagnosed?

The doctor will do a physical examination and ask about health history. Tests are not required to diagnose blepharitis. In some cases, your doctor may collect samples of oil or crust from your baby’s eyelid using a cotton swab. These samples are examined for fungi, bacteria, or any evidence of allergy (6).

How Is Blepharitis Treated?

Treatment will depend on your baby’s general health, age, cause of disease, and severity of symptoms. Your pediatrician may refer to an ophthalmologist in severe cases of blepharitis. The main goal of treatment is to ease the symptoms and prevent a recurrence.

If the infection is not controlled by general care, then your doctor may prescribe antibiotic ointments, teardrops, and other medications as required (7).

You could consider using non-pharmacological methods as well. The home treatment for blepharitis in babies includes the following measures (7)
(8).

1. Compress

  • Apply warm compress with the temperature close to bathwater, over the eyes for five to ten minutes.
  • Avoid using a heat mask since it may cause burns.
  • If your baby has acute blepharitis, then you may give warm compress up to four times a day.
  • Continue warm compress for three to four days or until the symptoms disappear.
  • The same can be done if your baby has blepharitis without stye (hordeolum).
  • If your baby has chalazion (small cyst or lump on the eyelid), then you may have to continue the warm compress for several weeks or months until it disappears.
  • If your baby has chronic blepharitis, then you may give warm compress once every day.

2. Hygiene

  • Clean the eyelid with an ophthalmic wipe or a mild soap solution.
  • You can prepare a mild soap solution using 10ml of baby shampoo diluted to 90ml of water.
  • Cleaning should be continued for three to four days until symptoms disappear in the case of acute blepharitis with or without stye.
  • Chronic blepharitis requires cleaning every day.

3. Massage

  • Massage is recommended mainly for chronic posterior blepharitis.
  • After using a warm compress, you may massage the eyelid once a day.
  • You should gently massage from the inner corner of the eye to the outer corner along the eyelid. It may help remove crusts and secretions from meibomian gland.

4. Local hydration

  • You may use preservative-free artificial tears as per the doctor’s recommendation.

If your baby has seborrheic dermatitis, your doctor may advise you to brush your baby’s hair softly while washing with a recommended baby shampoo. Your doctor may suggest using:

  • Antifungal shampoo or cream
  • Corticosteroid cream or lotion

Home remedies are often safe, but it is good to consult the doctor before use since the eye is a delicate organ.

Complications Of Blepharitis

Blepharitis could lead to the following complications (3).

How To Prevent Blepharitis In Babies?

Good hygiene practices may help you to prevent eye infections due to bacteria and parasites in your baby. You may also choose good quality baby products to avoid allergies. If you notice any symptoms of seborrheic dermatitis or roseola, consult your doctor and follow the recommended treatment to prevent further complications, like blepharitis
(9).

The condition of blepharitis often cures by itself with supportive care through home remedies. You may see a doctor to prevent any complication and risk of damage to the eyeballs. Long-term prognosis of the condition is good, and most babies seldom face any complications.

Do you have something to share about blepharitis in babies? Share your experience with us in the comment section below.

References:

1. Children’s blepharitis; Moorfields Eye Hospital NHS Foundation Trust
2. Blepharitis in Children; The University of Rochester Medical Center (URMC)
3. Blepharitis; The National Eye Institute (NEI); National Institutes of Health (NIH)
4. Blepharitis (Child); Fairview Health Services
5. Blepharitis in Children; Stanford Children’s Health
6. Blepharitis; Boston Children’s Hospital
7. Blepharitis; The Institut national d’excellence en santé et en services sociaux (INESSS)
8. Mary Eberhardt and Guhan Rammohan, Blepharitis; St Lukes University Health Network
9. Blepharitis; Oculoplastic Department, Singapore National Eye Centre ;The Singapore General Hospital

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