Blepharitis occurs when the tiny oil glands located at the base of the eyelids do not work properly, but the exact cause is not known. The condition can worsen when a person rubs their slightly sore and inflamed eyelids, causing further irritation and more inflammation. Development of blepharitis may be associated with a combination of factors including:
- Dandruff of the scalp and eyebrows (seborrhoeic dermatitis)
- Psoriasis, which is a common skin condition
- Excess growth of skin bacteria
- Rosacea, which is a skin condition that causes the face to turn red
- Allergies, especially to eye makeup and contact lens solutions.
Blepharitis can lead to complications, including the development of a sty (an infection of the eyelid oil glands), conjunctivitis (pink eye) and dry eye syndrome (when the eyes do not produce sufficient tears). Lack of lubrication might make it uncomfortable to wear contact lenses.
Typical signs and symptoms of blepharitis include:
- Eyelids that are red, itchy and swollen
- Eyes that feel gritty or burning
- Flaking of the skin around the eyes, similar to dandruff
- Formation of dandruff on the eyelashes
- Crusted eyelashes and eyelids ‘glued together’ on waking up
- Increased sensitivity to light
- Loss of eyelashes or uneven growth of eyelashes.
Both eyes are usually affected but one eye can be more severely affected than the other. Careful examination of your eyelids and eyes is usually sufficient for your doctor or optometrist to diagnose blepharitis.
Self-hygiene is often the only treatment necessary for blepharitis, initially to reduce the severity of symptoms and then to keep those symptoms under control. A three step process is sometimes recommended, involving warmth, gentle massaging and cleansing.
The warmth can be applied with a facecloth soaked in very warm water for a few minutes. Applying this to the eyes can loosen up oil that may be clogging the eyelid glands. Immediately following that, gently massage the closed eyelids with your finger to further loosen and push oil out from the glands. Finally, clean the eyelash area of the lids using a clean facecloth or cotton bud soaked in diluted baby shampoo. This routine can be repeated two times a day to help settle symptoms down and then daily, or every other day, to keep symptoms under control.
You should see your doctor if your blepharitis persists despite good eye hygiene. Your doctor may prescribe antibiotic eye drops to treat infection, corticosteroid eye drops or ointments to control inflammation, and/or lubricating eye drops or artificial tears to relieve dry eyes.
Blepharitis associated with other diseases or conditions may be controlled by treating the underlying disease or condition. Even with successful treatment, blepharitis often returns.
Good self-hygiene will help prevent blepharitis, as will avoiding anything that causes or aggravates the condition. Use of an anti-dandruff shampoo may help to prevent blepharitis if dandruff of the scalp is contributing to the blepharitis.
Mayo Clinic (2015). Blepharitis (Web Page). Rochester, NY: Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/blepharitis/symptoms-causes/syc-20370141 [Accessed: 26/01/18]
NHS Choices (2016). Blepharitis (Web Page). Redditch: National Health Service (NHS)
England. https://www.nhs.uk/conditions/blepharitis/ [Accessed: 26/01/18]O’Toole, M.T. (Ed.) (2013). Blepharitis. Mosby’s Dictionary of Medicine, Nursing & Health Professions (9th ed.). St Louis, MI: Elsevier Mosby.
Reviewed: January 2018