ZEST Treatment for Blepharitis

Blepharitis is an extremely common condition affecting more than 50% of patients I see in the eye clinic attending for other conditions. The word simply means ‘inflammation of the eyelids.’ The eyelids contain between 20-30 oil glands (meibomian glands) which secrete an oily substance that makes up part of the surface of the tear film. Bacteria love this oily material and inflammation leads to skin squares gathering along the margin of the eyelid and Demodex mites love to feed on these.

It is important to treat because for example in the cataract patient, eyelid inflammation and blepharitis can cause an inaccurate measurement for lens selection and an increased risk of intra-ocular infection post surgery. Aside from this, the condition causes discomfort and irritation that is unpleasant.

Traditional treatment advice is to apply hot compresses and use eyelid wipes such as Blephaclean or Optase once or twice daily to keep this under control. This is required on an ongoing basis and can be purchased from your local pharmacy or optician. The basis for these is to mechanically clear away the excess oil and debris that gathers along the lid.

In some cases, the debris is either very persistent or much more dense than normal and a deeper treatment is needed to clear the eyelid margins initially. This can be supplemented ongoingly with the more gentle eyelid wipes work for maintenance of eyelid health.

Zocular Eyelid System Treatment (ZEST) is made from refined extract of Okra, an edible green seed-pod. It has anti-bacterial and anti-Demodex properties and the mechanical action helps clear the eyelid margin. It has been found to reduce levels of matrix metalloproteinase-9, a marker of inflammation. Zest treatment is akin to seeing your dental hygienist for a deep clean. This works as an adjunct to regular brushing and flossing to maintain long-term health in cases of blepharitis that is more severe.

ZEST is supplemented with a gel called Zocushield, that can be applied to the eyelid margin once or twice a day and has antibacterial properties that helps maintain eyelid health and gives a more long-lasting effect.

Eyelid disease and blepharitis is not the same in every patient and prior to treatment, a full examination is required. It may be that there is exposure and incomplete eyelid closure, floppy eyelid syndrome, en/ectropion or canaliculitis to name a few. Rosacea is one of the more common conditions that affects the skin of the face and is associated with blepharitis. The redness of the facial skin is due to inflammation and often Demodex mites. In such cases, as well as removing the crusts and treating the eyelids, Optilight IPL can be combined with ZEST treatment to help settle this redness and inflammation as well as reducing the number of Demodex mites living on the skin. Optilight works well in conjunction with Zest, by acting to reduce the drivers for inflammation and well as having the margins ‘deep-cleaned’ by the ZEST treatment. In short, ZEST will bring the eyelids back to a healthy baseline and a course of Optilight IPL will help to maintain it.