Blepharitis occurs when the glands or eyelash follicles become blocked and infected, causing redness, swelling and irritation at the edges of the eyes. Blepharitis is common in children and adults and usually appears in both eyes at the same time.
Although blepharitis may seem minor, it can be uncomfortable, unsightly and difficult to resolve. Left untreated, it can lead to other eye conditions, including styes and conjunctivitis – so it’s important to see your ophthalmologist if you notice symptoms.
Causes and associated conditions
The exact cause of blepharitis can be difficult to pinpoint. While a bacterial infection in the eyelid is usually present, underlying conditions and irritants in the eye can be the initial cause of the infection. Dry eye, rosacea, eczema, dandruff, chemical fumes or smoke, injuries to the eye and even eyelash lice are associated with blepharitis.
Very rarely, blepharitis is related to a growth in the eyelid, such as a basal cell carcinoma or rodent ulcer.
Signs and symptoms
The most obvious signs are swelling and redness at the margins of the eyelid. Anterior blepharitis affects the lower lid and posterior is in the upper lid – you may need to lift the eyelid to see it.
A feeling of an object in the eye
- Scratchiness or itchiness
- Watery eyes
- Frothy tears
- Excessive blinking
- Light sensitivity (photophobia)
- Crusty or sticky eyelashes
- Painful or tender eyelids
- Thickening and redness at the edge of the eyelids
- Loss of eyelashes
Your ophthalmologist should be able to diagnose blepharitis through a simple eye exam – possibly using a slit lamp to get a close look.
In some cases, blepharitis won’t be fully resolved, but long-term treatment can keep symptoms under control.
Because blepharitis often starts with an infection in the eyelid, treating that is the first step. An antibiotic ointment can be applied to your affected eyelid using a cotton bud once or twice daily. In severe cases, your ophthalmologist may prescribe oral antibiotics.
If your blepharitis is caused by an underlying condition, such as dry eye or dermatitis, treating that may also help clear the inflammation in your eyelids. This may involve input from your ophthalmologist or GP.
Treat your Blepharitis at our Dry Eye Clinic.
Caring for the eyelid
A regular eyelid care routine may help resolve the condition or manage symptoms long-term. At first, you will need to go through the routine twice a day, then once or twice a week when inflammation is under control.
Step 1: Massage (posterior)
Wash your hands thoroughly, then gently massage the edge of each eyelid in a rolling motion, working inwards (as shown). This helps to break down any blockages and drain the meibomian glands.
Step 2: Clean (anterior)
Gently wipe the eyelid using a clean tissue or cotton bud and warm water. Your ophthalmologist may recommend using a few drops of baby shampoo or another gentle cleanser or give you special cleansing wipes to use – ask about your options.
Step 3: Compress
Wet a clean flannel or tissue with warm water and press to the margin of the eyelid for a minute or two. If needed, add salt or bicarbonate to the water to loosen crusted material and relieve pain.
General care tips
Avoid rubbing or scratching your eyelids, and always wash your hands thoroughly before starting your care routine. Use a clean cloth, tissue or cotton bud for each eye. During treatment, don’t use eyeliner, eyeshadow or mascara, as these can aggravate the condition. Contact lenses can also be irritating, so they should not be worn until symptoms are under control.