Meibomite: Causes and Treatment

Inflammatory processes of different etiology can affect not only the structure of the eyes, but also the eyelids, and since the eyelids - also part of the visual apparatus, pathological changes carry the potential danger of lowering view.In most cases, inflammatory processes develop with infection of the eyelash follicle and are called barley.However, sometimes there is a penetration of microbes into the sebaceous (meibomian) glands located near the eyelashes and having a length of at least half a century. That is why, during their blockage and inflammation, the abscess starts to form not at the edge of the eyelid, but at some distance from it.Such a disease is called meibomite (inner barley).

Definition of disease

Meybomievy glands - mutated sebaceous glands, reaching the edge of the eyelids.

In each gland the entire alveolus is opened along its entire length, which secretes the secret of fatty nature. Secret functions - lubricate eyelids, protecting their edges from wetting with tears. In humans, 30-40 meibomian glands in the upper eyelid and 20-30 in the lower eyelid. This secretion of the human eye contains about 90 proteins.

The structure of the century

Infection and blockage of one of the glands lead to a rapid formation of edema at the site of inflammation. Outside, the eyelid swells and turns red, and a purulent abscess forms on the inner surface.

Types and Classifications

By the nature of the leakage there are two forms of the disease:

• Acute meibomiteresembles ordinary barley, differing only in the localization of the focus of inflammation. The formation of the abscess occurs in the depth of the cartilaginous layer of the eyelid. Therefore, in the acute form of the disease, the degree of lesion is clearly visible only in the inverted century;
• Chronic meibomiteis manifested by a change in the conjunctiva, reddening and swelling of the edge of the eyelids. The color of the internal abscess is dirty yellow, the edges of the eyelashes and at the corners of the eyes form yellow crusts. With this form, chronic conjunctivitis develops.

The acute form of the disease is characterized by spontaneous dissection and excretion of the contents through the eye. With this form of the disease, there may be frequent relapses.

There are also meibomite upper and lower eyelids, which can occur with the same frequency.The formation of an abscess more often in the upper eyelid is caused by a large number of glands. The disease of the lower eyelid is characterized by a lower intensity of pain syndrome, which is due to its lower mobility.

Causes

The main cause of meibomitis development is bacterial infection, the causative agent of which most often is Staphylococcus aureus (in 90%).Much less often the infection is provoked by viruses, fungi, demodex mite.

Infection and introduction of pathogenic microflora occurs only with the development of dysfunction of meibomian glands, which can be provoked by a number of factors:

• Non-observance of eye hygiene: prolonged wearing of contact lenses and improper storage, touching the conjunctiva with dirty hands, using other people's cosmetics;
• Increased eye strain, associated with prolonged work on the computer, stay in a room where the air is dirty, dusty or dry;
• Frequent manifestations of allergy, leading to edema of the conjunctiva;
• Chronic somatic diseases: diabetes mellitus, acne rosacea, pancreatitis, seborrheic dermatitis, gastrointestinal dysfunction, eczematous conjunctivitis, problems with respiratory organs, inflammation of the oral cavity;
• Hormonal disorders;
• Hyperfunction of meibomian glands.

All these factors to some extent contribute to the weakening of immunity, and with the penetration of microbes into the gland they do not meet with worthy resistance.

Symptoms

The onset of inflammation in the eyelid can be diagnosed by characteristic signs:

• Thickening of the eyelid and its strong reddening;
• The surface of the inner side becomes bumpy;
• There is a burning sensation and severe itching;
• There is discomfort in case of blinking and strong lacrimation;
• Touching the site of inflammation causes severe pain;
• On the side of the diseased eye, there is an increase in the closest located lymph nodes;
• The formation of an abscess on the inner surface of the eyelid begins.

  The manifestation of meibomite

If the disease is violent, a turbid yellowish liquid is released. When it blinks, it spreads all over the edge of the century.

As with the development of barley, a greatly enlarged and long-uncovered abscess can cause a deterioration in overall well-being: fever, an increase in t, a general malaise.

Possible complications

A prolonged inflammatory process in the thickness of the cartilaginous tissue of the century without adequate treatment or complete absence of it can cause a number of serious complications:

• Chronic form. The main difficulty in the transition of the disease to a chronic course is that it can not be cured so easily as the process has affected deeper structures. The disease will constantly recur and affect the visual acuity;
• Conjunctivitis.When spontaneous dissection of the abscess, pathogenic microbes can penetrate into the mucosa, if the moment of the condition will be favorable: a decrease in immunity, the presence of chronic pathologies, supercooling;
• Blepharitis.If the disease becomes chronic, infection can penetrate the follicles of the eyelashes and become complicated by fungal or viral infections, allergenic irritations;
• An abscess of the orbit of the eye. Frequent and prolonged inflammations can cause the formation of an abscess - a limited inflammation in the tissues of the orbit, characterized by the formation of a pus filled with pus.

In the absence of correct treatment of the chronic form of meibomitis, it is possible to develop severe pathologies: thrombosis cavernous sinus, thrombophlebitis of the orbital veins, inflammation of the meninges, loss of vision, sepsis (infection blood).

Diagnostics

Initial examination of the ophthalmologist and questioning the patient in most cases give a clear picture of the disease and are sufficient to make a diagnosis.If the etiology is unclear, the doctor may prescribe additional studies:

• General and biochemical analysis of blood and urine;
• Bacterial sowing of eye discharge on the microflora;
• PCR for the presence of bacterial, viral or fungal pathologies;
• Blood samples for antibodies to helminths and allergens;
• Investigation of eyelashes for the presence of the demodex mite.

  Bacterial sowing when tested for meibomite

Treatment

Based on the diagnosis, the extent of the patient's damage, the state of his overall health, the doctor makes the scheme of therapy that is most effective for this particular case.

Medicines

Medication therapy includes the following activities:

• Removal of crusts and scales from the ciliary line using a solution of children's shampoo up to 3 times a day;
• Use of antibacterial ointment(Tetracycline) for bookmarking at night. As a substitute, 1% mercury ointment can act;

  Tetracycline is used in the treatment of meibomite

• Use of other antibacterial agentsduring the day as directed by a doctor. These can be Tobramycin, Sofrax, Floxal, Ciprofloxacin;
• Conjunctival lavageantiseptics (okomistin);

  Ocomistin is used to flush conjunctiva

• Elimination of symptoms of inflammationanti-inflammatory agents (Diklo F);
• With hyperfunction of the meibomitic glands - ingestion of Tetracycline or Doxycycline, as prescribed by the doctor;
• In the acute course of the processit is necessary to avoid the use of lotions and trays, and use only dry heat, wipe the affected area with alcohol or its solution up to 3 times a day;
• When chronic form should be used to strengthen the immune system: vitamin complexes with vitamin B content.

Treatment meibomite, as well as the use of medicines, should only take place under the supervision of a doctor, since there is a threat of the transition of the disease into a chronic process or a spontaneous dissection.

Methods of physiotherapeutic treatment, as well as massage of the eyelids, are effective methods of additional therapy to eliminate meibomitis and prevent complications.

Surgically

With prolonged drug treatment of the disease with no visible effect, the only way to get rid of the abscess becomes its surgical opening.This happens in a medical institution with the involvement of qualified specialists. A similar method is used to treat cholaziones of the eyelids.

If the disease takes a chronic form, in most cases it is treated surgically.The essence of the method consists in removing, together with the capsule, the formation through a small incision on the inner side of the eyelid after local anesthesia. Obligatory condition is the subsequent histological research with the purpose of confirmation of good quality.

Surgical removal of meibomite

Folk remedies

Treatment meibomita folk remedies should be conducted after consultation with an ophthalmologist and only at the very beginning:

• Make a compress from a cotton pad soaked in vodka or diluted with alcohol to the area of ​​the beginning inflammation.Lightly press the disc to prevent penetration of vodka into the eye;
• Make infusion of 3 tbsp. l. dry psyllium in 200 ml of water, filter and use for lotions;
• A tablespoon of dried marigold flowerspour boiling water, insist not less than, h. and apply a strained infusion for lotions and washes;
• Fresh aloe juicedilute with boiled water 1: 10 and use for lotions;
• Dilute 1 tbsp. l. soda in a glass of boiled water, do lotions three times a day with the appearance of itching;
• In a castor oil moisten a gauze napkin and fix it with a plaster on the eye before going to bed.Keep the compress for the night. For complete cure, 2-3 procedures are sufficient.

Treatment meibomite independently is possible only at the stage of onset of inflammation. As soon as the abscess starts to form, any warming procedures can trigger the activation of the process and the opening of the abscess not outward, but inside the eyelid. Therefore, home treatment should always be agreed with the doctor.

Prevention

To prevent the inflammation of the meibomian gland, you should pay attention to a few simple recommendations:

• Constantly observe the hygienic rules;
• Store and use contact lenses only as directed;
• Use only high-quality and non-overdue cosmetics and perfumes;
• Keep blood sugar in check, especially after 40 years;
• Avoid swimming in water with polluted water;
• Lead a healthy lifestyle: rational nutrition with sufficient content of natural vitamins, motor activity, lack of stress, gradual hardening.

In the development of meibomite, a huge role is played by the state of the immune system of the whole organism, so the last point is especially important.

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conclusions

Like most infectious processes, meibomite has good chances for development only in the absence of adequate protection. However, our immunity is "busy with other things so do not provoke the infection with dirty hands or using someone else's personal belongings, i.e. observe the hygiene of the eyes.

Avoid the development of the disease is easy enough with a responsible attitude towards prevention, but if the process does begin, do not delay the visit of an ophthalmologist.With proper and timely treatment, the disease will pass in the lightest form and without complications.