What is Blepharitis, what are Blepharitis Symptoms, and why does it cause Dry Eye

Before you start trying all sorts of treatments for Blepharitis, it's important to first understand what Blepharitis is, and especially that it’s multifaceted. Some treatments only deal with one aspect but you need to deal with all of them to be successful.

I am not a medical doctor so please do not take this as medical advice. Merely sharing the understanding I have gained from doctors and research through the years 😊.
 
So here’s my simplified explanation:
There are two types of blepharitis, anterior blepharitis, and posterior blepharitis.

Anterior Blepharitis: This can be caused by a chronic staphylococcal infection, where some people are more sensitive to bacteria on the skin of the eye lids and eye lashes which cases infections, and can (I believe) also contribute to the restriction of glands.

Posterior Blepharitis: This is most associated with malfunction of the meibomian glands. Your eyelids contain glands that secrete a thin layer of oil over the eye, which helps to prevent moisture (from tears) from leaving and increases comfort. In cases of Blepharitis these glands become blocked, thereby failing to provide this protection and creating a feeling of constantly dry eyes. More crucially, they can start working against the eye as trapped oil builds up in the glands, eventually drying or forming solid pieces and breaking off into the eyes, creating a “sand in eyes sensation”. Hence the term Meibomian Gland Dysfunction (MGD), often used interchangeably with Blepharitis.
 
So when dealing with Blepharitis, it's important to tackle all potential causes! In other words not just the blockage of glands but also potential for bacterial intolerance. Hence why I advocate the dual approach of a warm compress to unblock the glands, and lid hygiene to remove bacteria that could be a part of the problem, as detailed in my 4 step routine here.

What were my symptoms?
 
It might be useful for us to compare symptoms, so here were mine:
 
1. “Sand in eyes” feeling.  I had constant sense of having particles in my eyes and scratching against my eyelids, but never visible to actually remove. This was the worst of them all, often to the point where I couldn't sleep!
2. Dry eyes. No matter how many eye drops of different types I pumped in, this persisted. It's obvious in hindsight given that my tears were not being retained due to my dysfunctional glands not proving that tin film of oil to keep moisture locked in. I work in mainly front of a computer which I'm sure only exacerbated things.
3. Constant Allergic Conjunctivitis Attacks. This happened once a month at the height of my symptoms. If I woke up with crust around my eyes, I knew it was conjunctivitis time! This meant another expensive prescription for more eye drops, some of which would make the redness worse.
4.  Severe redness. The truly demoralising type, and sometimes traffic light red! All the rubbing of my eyes when I had the feeling of "sand in eyes" definitely didn't help
5. Poor Mental Health: No-one ever talks about this, but all of this really ruined my self-esteem over the years. I plan to tell more about this in a full post, but it's fair to say I'm still undoing some of the damage to my confidence caused by going 12 years without a suitable treatment for my blepharitis.

So that's my understanding gathered through the years. I hasten to repeat that I AM NOT and medical doctor. Just a person who's spoken to countless doctors over the years.

Please do share what you've learned in the comments below!!