Alternative treatments for blepharitis
Alternative treatments for blepharitis focus on alleviating irritation and inflammation of the eyelids and eyelashes through various natural and dietary approaches. The condition can manifest in two forms: anterior, associated with bacterial infections or skin conditions, and posterior, linked to inflammation of the oil-secreting glands in the eyelids. While traditional treatments primarily emphasize eyelid hygiene and, in some cases, antibiotic or steroid eye drops, alternative options have garnered interest among individuals seeking holistic remedies.
N-acetylcysteine (NAC) stands out as a principal proposed treatment, thought to support the body’s antioxidant defenses and help clear blockages in the oil glands. Other suggested alternatives include a range of vitamins (such as A, C, and E), omega-3 fatty acids, and various herbs, including chamomile, tea tree oil, and manuka honey, which may possess anti-inflammatory and antibacterial properties. However, it is important to note that scientific evidence supporting the efficacy of these treatments is limited, and potential risks are associated with using herbal preparations in the eyes. Individuals exploring these alternatives should do so under the guidance of qualified healthcare providers, particularly considering the close relationship between blepharitis and other skin conditions like seborrheic dermatitis and acne rosacea.
Alternative treatments for blepharitis
DEFINITION: Treatment of irritation and inflammation of the eyelids and eyelashes.
PRINCIPAL PROPOSED TREATMENT: N-acetylcysteine
OTHER PROPOSED TREATMENTS: Barberry, bayberry, beta-carotene, bilberry, calendula, chamomile, citrus bioflavonoids, dandelion, evening primrose oil, eyebright, fish oil, goldenseal, lutein, passionflower, red clover, selenium, vitamin A, vitamin B complex (mixture of vitamins B1, B2, B3, B6, and B12, and pantothenic acid, biotin, folate, inositol, and choline), vitamin C, vitamin E, zinc, omego-3 fatty acids, tea tree oil, manuka honey
Introduction
Blepharitis is a common eye disease that affects the edges of the eyelids and the eyelash hair follicles. Symptoms include red and swollen eyelids, crusting of the eyelashes on awakening, redness of the eye, sensitivity to light, excessive tearing, frothy tears, and an itching, burning, or foreign-body sensation in the eye.
There are two forms of blepharitis: anterior and posterior. Anterior blepharitis involves the portion of the eyelid where the eyelashes attach. It is caused either by a bacterial infection or by part of the same skin condition that causes dandruff (seborrheic dermatitis).
Posterior blepharitis occurs when the oil-secreting glands inside the eyelid (the meibomian glands) become inflamed and, eventually, cannot secrete properly. This leads to changes in the liquid bathing the eye (the tear film). Like anterior blepharitis, posterior blepharitis may occur as part of seborrheic dermatitis. Acne rosacea has also been associated with the condition.
Treatment of blepharitis primarily involves various methods to keep the eyelids clean and free of crusts. In some cases, antibiotic or steroid eye drops are used.
Principal Proposed Treatments
N-acetylcysteine (NAC) is a specially modified form of the dietary amino acid cysteine. When taken orally, NAC is thought to help the body make the important antioxidant enzyme glutathione. NAC is also believed to help loosen secretions, and for this reason, it has been tried as a treatment for loosening the thick, crusty secretions that block the oil-secreting glands in posterior blepharitis.
In posterior blepharitis, the tear film becomes abnormal. A controlled but not blinded study evaluated the potential benefits of NAC in fifty people with chronic posterior blepharitis. All participants received standard eye care for blepharitis. In addition, about one-half of the participants received NAC at a dose of 100 milligrams three times daily for eight weeks. Researchers used various methods to objectively evaluate the quality of the tear film and found that the use of NAC brought about significant improvements.
Further research, including double-blind, placebo-controlled trials, is necessary to determine whether these apparent benefits translate into meaningful improvement for people with chronic blepharitis. In the meantime, a diet rich in omega-3 fatty acids likely aids in preventing the disease.
Other Proposed Treatments
For various theoretical reasons, other natural treatments have been recommended for blepharitis, including beta-carotene, citrus bioflavonoids, dandelion, evening primrose oil, fish oil, lutein, red clover, selenium, vitamin B complex (a mixture of vitamins B1, B2, B3, B6, and B12, and pantothenic acid, biotin, and folate, possibly with inositol and choline), vitamins A, C, and E, and zinc. However, no meaningful scientific evidence indicates that these treatments are helpful.
Certain herbs have been used, traditionally in the form of eye drops, to treat blepharitis and related conditions, including barberry, bayberry, bilberry, calendula, chamomile, eyebright, goldenseal, and passionflower. Other treatments, such as castor oil, coconut oil, and tea tree oil, can be helpful in reducing inflammation. Manuka honey, which has antibacterial and anti-inflammatory properties, may provide relief. However, there is no meaningful evidence to indicate that they are effective. Furthermore, using herbal preparations in the eye is risky and should not be attempted except under the supervision of a qualified healthcare provider. Natural treatments used for seborrheic dermatitis or acne rosacea may also be worth considering, as these conditions are closely related to blepharitis.
Bibliography
"Blepharitis - Diagnosis & Treatment." Mayo Clinic, www.mayoclinic.org/diseases-conditions/blepharitis/diagnosis-treatment/drc-20370148. Accessed 6 Sept. 2024.
"5 Benefits of Manuka Honey." Cleveland Clinic Health Essentials, 14 Mar. 2022, health.clevelandclinic.org/manuka-honey-benefits. Accessed 6 Sept. 2024.
Johnson, Gordon J., et al., editors. The Epidemiology of Eye Disease. 2nd ed., Oxford University Press, 2003.
National Institutes of Health, National Eye Institute. www.nei.nih.gov. Accessed 15 Aug. 2023.
Sutton, Amy L., editor. Eye Care Sourcebook: Basic Consumer Health Information About Eye Care and Eye Disorders. 6th ed., Omnigraphics, 2020.
Yalcin, E., et al. "N-acetylcysteine in Chronic Blepharitis." Cornea, vol. 21, 2002, pp. 164-168.