Blepharitis is a common and ongoing condition where the eyelids become inflamed (swollen), with oily particles and bacteria coating the eyelid margin near the base of the eyelashes. This annoying condition causes irritation, itchiness, redness, and stinging or burning of the eyes. While the underlying causes of blepharitis aren’t completely understood, it can be associated with a bacterial eye infection, symptoms of dry eyes or certain types of skin conditions such as acne rosacea.

Anterior blepharitis affects the outside of the eyelid where your eyelashes are attached. This can be caused by bacterial (or sometimes viral) infection. If left untreated, anterior blepharitis can lead to thickened and inward-turned or outward-turned eyelids and even vision problems from in-turned eyelashes damaging the cornea.

Posterior blepharitis is a condition that results from a dysfunction of the eye’s tiny oil glands (meibomian glands) in the eyelids at the base of the eyelashes. When meibomian glands become clogged from posterior blepharitis, it can also can cause a stye or chalazion to form. Posterior blepharitis also leads to thickened eyelid margins and crusty eyelids. With this type of blepharitis, tears can even look foamy.

Blepharitis-illustrationMany people have both anterior and posterior blepharitis at the same time in varying degrees.

Rosacea blepharitis is associated with ocular rosacea, a condition that causes eyelid swelling and redness due to malfunctioning oil glands.  Acne rosacea is a common skin condition that leads to pimple-like bumps and facial redness.

Symptoms of blepharitis include:

  • Eye and eyelid irritation
  • Crusting of the eyelid/eyelashes
  • Itchiness of the eye
  • Tearing
  • Redness in the eyelid margins and in the eye
  • Burning sensation
  • Foreign body sensation (something in the eye)

Who Is at Risk for Blepharitis?

Blepharitis frequently occurs in people who have a tendency toward oily skin, dandruff or dry eyes. This condition also is associated with meibomianitis — a problem of the nearby oil glands of the eyelids (called meibomian glands).

People who have acne rosacea, a common skin condition causing pimple-like bumps and facial redness, may suffer from ocular rosacea, which affects the eyelids with redness and swelling.

What Causes Blepharitis?

Everyone has bacteria on the surface of their skin, but in some people, bacteria thrive in the skin at the base of the eyelashes. Large amounts of bacteria around the eyelashes can cause dandruff-like scales and particles to form along the lashes and eyelid margins.

Other diseases and conditions that can cause blepharitis may include:

  • Malfunctioning of the meibomian eyelid oil glands
  • Seborrheic dermatitis (dandruff of the scalp and eyebrows)
  • Acne rosacea  (a skin condition that causes redness of the face)
  • Eyelash mites (tiny organisms in the eyelash follicles)
  • Allergic reactions to cosmetics or medications

Blepharitis Diagnosis

A close examination of your eyelids and eyelashes by an eye doctor is usually all that is needed to diagnose blepharitis. Your doctor may test your vision, perform a slit-lamp microscope exam, and test your eye pressure as well.

Blepharitis Treatment

Blepharitis is often a chronic, or ongoing, condition, but it can be controlled with the following treatments. Your ophthalmologist will help you identify which treatments are most appropriate.

Warm compresses
Wet a clean washcloth with warm water, wring it out, and place it over your closed eyelids for at least one minute. Repeat two or three times, rewetting the washcloth as it cools. This will loosen scales and debris around your eyelashes. It also helps break down oil from nearby oil glands. This prevents development of a chalazion (pronounced kuh-LAY-zee-un) — an enlarged lump caused by clogged oil secretions in the eyelid.

Eyelid scrubs
Using a clean washcloth, cotton swab or commercial lint-free pad soaked in warm water, gently scrub the base of your eyelashes for about 15 seconds per eyelid.

Antibiotic ointment
Your ophthalmologist may prescribe an antibiotic ointment. Using a clean fingertip or cotton swab, gently apply a small amount at the base of the eyelashes before bedtime.

Artificial tears or steroid eyedrops may also be prescribed temporarily to relieve dry eye or inflammation. A new antibiotic drop that also helps improve the oil secretions of the meibomian glands may be prescribed by your Eye M.D.

Nutritional therapy
Research suggests that a lack of certain nutrients may contribute to meibomian gland blepharitis. An imbalance of omega fatty acids has been found to cause abnormal secretions of the oil glands that help lubricate your eyes. Ask your ophthalmologist about a proper diet and nutritional supplements to help treat this imbalance.

Good hygiene
Because blepharitis can be an ongoing problem, you should regularly clean your skin and eyelids to keep blepharitis from returning. In addition to carefully cleansing your eyelashes, you can also wash your hair, scalp and eyebrows with antibacterial shampoo to help control blepharitis.