Blepharitis (DEBS)


Dry Eye/Blepharitis Syndrome (DEBS) is a chronic, inflammatory disease of the eyelids caused by an overgrowth of normal bacteria living along the lid and the base of the eyelashes. Anyone can get DEBS at any age, but the prevalence increases with age and with contact lens wear.

Staphyloccocus aureus and staphyloccocus epidermidis bacteria produce a biofilm that builds up over the years and allows the bacteria to greatly increase their densities. Once the population reaches a certain number, genes activate allowing the bacteria to produce toxins (quorum-sensing gene activation.) These toxins penetrate the eyelid tissue causing low-grade chronic inflammation which adversely affects the quality and quantity of tears being produced.

Since the eyelids are difficult to clean, this overgrowth of bacteria, biofilm, and toxins can worsen over the years, eventually causing significant damage to the eyelid and tear glands.

Now, thanks to BlephEx®, your eye doctor can precisely and safely, clean and exfoliate your eyelids and lashes, which should almost immediately improve your symptoms. More importantly, by completely removing the toxins and biofilm along the lid margin, your doctor helps you avoid long-term inflammatory damage to your tear glands, helping to treat or prevent chronic dry eye syndrome. The treatment only takes a few minutes and is well tolerated. Regular treatments can effectively result in a cure of dry eye disease in many patients.

Stage 1

Early biofilm formation with swelling of the lash follicles, lash misdirection

Stage 2

Inflammation of meibomian glands with plugging

Stage 3

Lacrimal involvement leads to aqueous insufficiency with little to no tear lake

Stage 4

Chronic inflammation leads to a breakdown in the structural integrity of the eyelid leading to lid laxity and eventually ectropion

How BlephEx® Works

BlephEx® is a painless in-office procedure performed by your eyecare professional or trained technician. A revolutionary new patented BlephEx® handpiece is used to very precisely and carefully, spin a medical grade micro-sponge along the edge of your eyelids and lashes, removing scurf and debris and exfoliating your eyelids.

The patented micro-sponge is disposable and for optimal cleaning and exfoliating, a fresh clean one is used for each individual eyelid. The eyes are rinsed well afterwards.

The procedure lasts about 6 -8 minutes and is well tolerated. Most patients simply report a tickling sensation. A numbing drop is usually placed in each eye prior to treatment for increased comfort.

After the procedure, the patient is instructed on how to maintain their clean eyelids with regular nightly lid hygiene. Since home treatments are only semi-effective, the procedure is typically repeated at 4-6 month intervals.

1. How does BlephEx work?

Answer: Blepharitis and Dry Eye Disease is caused by a low-grade, chronic inflammation of the eyelids, that gets worse throughout a patients lifetime, damaging the glands that produce normal tears and eventually leading to blepharitis and dry eye disease.

BlephEx is a doctors treatment that removes the source of inflammation by cleaning off the biofilm from the lid margin, like a dentist removing plaque during a teeth cleaning. This biofilm is produced by the normal bacteria living on the lid margin, so it will eventually return to cause inflammation again, so the treatment should be repeated every 4 to 6 months.

2. Where can I get a BlephEx procedure performed?

Answer: BlephEx is performed in doctors offices all over the world. On our website go to our DOCTOR LOCATOR MAP (make this an active link) to find a practice near you who performs the treatment. Enter your zip code or use the + (plus) button to simply zoom in to your area.

3. Does insurance cover the cost?

Answer: No, BlephEx is a brand new treatment for dry eye and is not covered by insurance. It is a private pay procedure but will typically be less expensive than a years worth of prescription drops, artificial tears, ointments, copays, etc, that have little to no effect on your disease.

4. How much will it cost?

Answer: We don’t keep track of what offices charge for BlephEx. Each practice is different depending on geographic location. The best thing to do is to call the practice near you and find out.

5. How soon will I notice a difference?

Answer: It really depends on the stage of your blepharitis/dry eye disease and how many years you have had it. Many patients feel a difference before they leave the doctors practice. But if you have sustained significant damage to your tear glands, it may take months before you notice a difference. Some people need multiple treatments before they begin to feel better. Vigilance and repeat treatments are the key to treating, curing and then preventing recurrence.

6. How common is blepharitis or dry eye disease?

Answer: It has been estimated that up to 2/3 of all patients walking into an eye doctors office have some level of lid margin disease.

7. How many times should I have the BlephEx procedure performed?

Answer: Just like the mouth is full of bacteria and needs constant and regular hygiene to prevent gingivitis, so do the eyelids need constant and regular hygiene to prevent blepharitis and dry eye disease. It is recommended that BlephEx be repeated every 4 months for an active disease, and every 6 months for contact lens wearers. This keeps the number of bacteria to a minimum, and helps prevent a reformation of the biofilm. If the treatments are stopped, the biofilm will reform, the chronic inflammation will return, and the tear glands will once again be damaged.

8. Does BlephEx hurt?

Answer: Your doctor will put in numbing drops which make the treatment very well tolerated. Most patients report a tickling sensation, but no pain. The harder your doctor presses on your lids during the treatment, the MORE comfortable the treatment will be!

9. Will BlephEx treatment interfere with my glaucoma medicines?

Answer: No, it is recommended you continue all of your other drops that any eye doctor has you on.

10. Can I perform BlephEx at home?

Answer: No, due to the close proximity of the eye, BlephEx is only to be performed by a professional eye care specialist or trained staff, in an office or hospital setting.

11. I wear contact lenses. Should I have a BlephEx procedure on my eyelids?

Answer: Absolutely yes. Contact lens wearers are 10 times more likely to develop an early biofilm and will get inflammatory damage to their tear glands much earlier in life. Having regular BlephEx treatments performed every 6 months will keep your tear glands healthy and help you avoid a condition known as “Contact Lens Intolerance”, a condition in which the eye begins to reject the wear of a contact lens due to constant exposure to the inflammatory factors of the biofilm.

12. Are there any side effects?

Answer: The main side effect is that your eyes are going to feel better than they have felt in years. You just had a 30, 40, 50, even 60 year old biofilm removed from your eyelid. You will finally be able to blink more easily without your lids feeling sticky. Most patients say that they feel a slight irritation afterwards along with a little bit of redness that typically resolves within a few minutes or hours. After all, you just had your biofilm removed from your eyelids for the first time!