Blefaritis

blefaritis
 

La blefaritis es una causa muy frecuente de malestar e irritación oculares que nos obliga muchas veces a consultar a nuestro médico.

¿Qué es la blefaritis?

Consiste en una inflamación del borde palpebral que suele afectar a los dos ojos aunque de forma asimétrica. Su manejo suele llevar mucho tiempo y ser en ocasiones ineficaz.

 ¿A quién puede afectar?

La blefaritis puede afectar a cualquier persona pero es más frecuente en aquellos pacientes que ya están diagnosticados de dermatitis atópica, dermatitis seborreica o rosácea.

¿Qué tipos de blefaritis existen?

Identificar el tipo de blefaritis es importante porque el tratamiento y la gravedad pueden variar ligeramente.

Existen dos tipos de blefaritis:

  • Blefaritis anterior: la inflamación afecta al área que rodea la base de las pestañas (parte externa del borde palpebral). Puede deberse a una infección bacteriana crónica o a una enfermedad cutánea como la dermatitis seborreica.
  • Blefaritis posterior: la inflamación afecta al borde posterior del párpado. Se debe a la disfunción de las glándulas que existen en dicha localización denominadas glándulas de Meibomio y a alteraciones de su secreción.A menudo se presentan ambos tipos a la vez denominándose blefaritis mixta.

¿Que clinica produce la blefaritis?

La sintomatología de los distintos tipos de blefaritis es similar, existiendo escasa la correlación entre los síntomas y signos.

Generalmente es asintomática pero puede cursar con irritación, picor, sensación de arenilla, lagrimeo, quemazón e incluso en ocasiones pinchazos. Las molestias se acentúan típicamente por las mañanas y se caracteriza por remisiones y exacerbaciones.

¿Cuáles son las complicaciones de la blefaritis?

  1. ORZUELO:

Las glándulas de Meibomio, de las que ya hablamos antes, producen un líquido graso que forma parte de la lágrima. Con frecuencia estas glándulas se infectan produciendo orzuelos. Los orzuelos se presentan como una masa circunscrita, enrojecida y dolorosa. Es frecuente que se asocie un edema del párpado perilesional.

  1. CHALAZIÓN:

Es una inflamación secundaria a una retención crónica del líquido graso en las glándulas de Meibomio. Es indolora y los signos inflamatorios son muy discretos.

  1. OJO SECO:

La blefaritis suele complicarse con un síndrome de ojo seco, una dolencia que es probable que obstaculice el buen funcionamiento de la córnea. Para ello el oftalmólogo recomienda el uso de lágrimas artificiales tantas veces al día como aparezcan molestias.

¿La blefaritis es contagiosa?

La blefaritis NO ES CONTAGIOSA aunque eso no impide que varios miembros de la familia puedan padecerla a la vez.

¿La blefaritis tiene tratamiento?

Sí. El tratamiento de la blefaritis consiste en la higiene y limpieza de párpados. Puede realizarse una o dos veces al día inicialmente y posteriormente disminuir la frecuencia a una o dos veces por semana. Hay que tener cuidado de no producir una irritación mecánica por el frote excesivo de la piel del párpado.

¿Cómo debo realizar la limpieza de parpados?

Se deben seguir estos pasos para una buena higiene:

  1. Se aplica en primer lugar una compresa caliente durante varios minutos para ablandar las costras de la base de las pestañas. Antes de que se enfríe la compresa cámbiela.
  2. Realice un masaje ejerciendo una ligera presión sobre los párpados. Este masaje permite expulsar las secreciones de grasa de las glándulas de Meibomio tras el calentamiento. El masaje consiste en realizar una presión con el dedo índice hacia dentro por encima de las pestañas del párpado superior y por debajo de las pestañas del párpado inferior.
  3. A continuación se procede a la limpieza del párpado para eliminar mecánicamente las costras y otros residuos. Frote los bordes de los párpados con un bastoncillo de algodón o un paño limpio empapado en una dilución templada de champú de bebé. Se han comercializado toallitas especiales que suelen ser muy eficaces.

¿Hasta cuando tendré estas molestias?

La blefaritis NO TIENE CURA pero puede controlarse. Por lo tanto nunca desaparecerá por completo pero podremos disminuir los síntomas mediante la realización de un tratamiento adecuado.

Las recaídas aparecerán cuando interrumpamos o disminuyamos demasiado la frecuencia o intensidad del tratamiento o bien cuando nos expongamos a condiciones externas desfavorables.

¿Cómo puedo evitar los síntomas y las complicaciones?

Seguir el tratamiento de forma adecuada y sistemática ayudará a mejorar la clínica en la inmensa mayoría de los casos.

La higiene palpebral es la clave del éxito aunque es posible que tanto nuestro médico como el oftalmólogo puedan recetarnos algún fármaco durante un periodo corto de tiempo.


Cecilia Díez Montero
Médico Residente de Oftalmología, HURH, Valladolid

 
 
 

REFERENCIAS:

  • Brad Browling. 2016. Kanski; Oftalmología clínica un enfoque sistemático. 8ª edición. Barcelona. Elsevier.
  • Miguel José Maldonado López y José Carlos Pastor Jimeno. 2012. Guiones de oftalmología. Aprendizaje basado en competencias. 2ª edición. Madrid. Mc Graw Hill.

 
Revisado: noviembre 2016
 
 
 

412 comentarios en “Blefaritis”

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