Blepharitis

Blepharitis (pronounced blef-uh-RYE-tis) is inflammation of the eyelids, mainly affecting the area where the eyelashes grow. Symptoms can include red, itchy, and swollen eyelids. It is a common disorder that can occur at any age. Blepharitis can be a chronic (long-lasting) condition that can be difficult to treat. It is not contagious.

Causes

Blepharitis occurs when the tiny oil glands located at the base of the eyelids do not work properly. 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.

Symptoms

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
• 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.

Complications

Blepharitis can lead to complications, including:

• The development of a stye (infection of an eyelid oil gland)
• Conjunctivitis (pink eye)
• Chalazion (a hard lump caused by inflammation of an eyelid oil gland)
• Excess tearing or dry eyes (due to abnormal or decreased oil secretion).

Treatment

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 massaging the closed eyelids with a clean finger will help 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, rinse with warm water, and then gently pat dry with a clean towel.

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.

Where blepharitis is associated with other diseases or conditions, it may be controlled by treating the underlying disease or condition.

Prevention

Good self-hygiene will help prevent blepharitis, as will avoiding anything that causes or aggravates the condition, e.g., refrain from using eye makeup when your eyelids are inflamed. Use of an anti-dandruff shampoo may help to prevent blepharitis if dandruff of the scalp is contributing to the blepharitis.

References

Mayo Clinic (2020). Blepharitis (Web Page). Rochester, MN: Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/blepharitis/symptoms-causes/syc-20370141 [Accessed: 11/01/21]
NHS (2019). Blepharitis (Web Page). Redditch: National Health Service (NHS) England. https://www.nhs.uk/conditions/blepharitis/ [Accessed: 11/01/21]
O’Toole, M.T. (Ed.) (2017). Blepharitis. Mosby’s Dictionary of Medicine, Nursing & Health Professions (10th ed.). St Louis, MI: Elsevier.

Reviewed: January 2021

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