Blepharitis is a very common condition affecting the eyelid edges. It typically results in dry, gritty, uncomfortable eyes, which can also look red-rimmed. There are a number of reasons why you can develop the condition:

  • Excess of bacteria called Staphylococcus on the eyelid
  • Atopic conditions like Rosacea and dermatitis
  • Microscopic mites called Demodex

The ultimate aim is to establish the cause and then reduce the discomfort and symptoms associated with the condition. We will help to reduce the impact of the condition in the future and stop it getting worse. Typically once we have diagnosed you with blepharitis we will see you on a 6 monthly basis to deep clean the eyelids and clear out the meibomian glands if required.

We also target Demodex blepharitis with a very effective Tea Tree Oil formulation to kill the mites on the eyelids. Ongoing appointments can be covered as part of our VisionCare direct debit plan or as a pay as you go basis.


We see an awfully large amount of symptomatic blepharitis patients where conventional treatments haven’t helped them as much as they had hoped. Compliance seems to be the chief complaint – when patients are working and leading hectic lives, it’s difficult for them to take time out for a heat therapy and a lid wipe session. As a result, we began to explore what other options were out there and if we could do anything else to help.

“The Bleph-Ex is a fantastic new tool we have added to our armory in the fight against blepharitis”

Blepharitis is probably the most common disease seen in practice. Most patients have it and it becomes more prevalent as we get older. Typically, the lid margin appears reddened and the lashes show a characteristic crusting, which leads to patients seeking advice. These anterior signs usually have a causative seborrheic component and an infective element related to Staphylococcal infection. The latter often promotes chronic disease with lash loss and tougher-to-remove lid debris. Posterior to this, meibomian gland involvement with blocked gland openings and sebum build-up adds to the irritation and also destabilises the tear film. A major problem with blepharitis is its persistence and recurrence, and there isn’t a ‘one-size fits-all’ solution. However, we have a neat little device that helps.

Bleph-Ex basics

Any patient with an insufficient tear film may be prone to a build-up of bio-film along the eyelids. Debris on the ocular surface is not being cleaned away by the tears and as the lids blink across the surface they pick up the debris, which eventually builds into a bio-film covering the meibomian gland heads. The bio-film can contain bacteria and Demodex causing inflammation and further inhibiting the flow of oils. If left blocked for a prolonged period atrophy can leave the meibomian glands ineffective. Hence having an effective way to remove this bio-film is essential. This is where the Bleph-Ex comes in.

A highly absorbent disposable micro-sponge is soaked in solution and spun along the eyelids; the spinning mechanism targets the bio-film and removes the debris. A new micro sponge is used for each eyelid to give optimal cleaning and exfoliation. Think of it as an electric toothbrush for the eyelids.

The procedure is completely painless and the lids are cleaned both posteriorly and anteriorly then rinsed well afterwards. All in all the session lasts about 10 minutes. Like dental patients see a hygienist at regular intervals to remove plaque, blepharitis patients would also benefit from a regular appointment to exfoliate their eyelids.

Patients who would be most suitable for Bleph-Ex treatment are typical contact lens wearers, dry eye sufferers and office workers. However, it can be recommended to almost anyone, including those who are simply keen to get on top of their hygiene with minimal effort.

Like dental patients see a hygienist at regular intervals to remove plaque, blepharitis patients would also benefit from a regular appointment to exfoliate their eyelids. Initially, a six-monthly treatment is recommended. This is in combination with a hygiene care plan as recommended above.

The Bleph-Ex is another tool we have added to our armory in the fight against blepharitis. However, it is not a replacement for heat therapy, lid wipes and ocular lubricants and it should be used in combination. Nonetheless, it gives us great satisfaction to offer our patients something more. We are the only practice in Christchurch privileged to have access to a Bleph-Ex and one of only a few on the south coast.