What is Blepharitis?

Blepharitis occurs when 1 or both eyelids become inflamed, red, irritated, and perhaps itchy. It is a common disorder of the eye that can develop in 1 or both eyes.1-3

Blepharitis often happens when oil glands at the base of the eyelashes are clogged. It can also be the result of bacteria, dandruff, mites, or skin conditions like rosacea.1-3

Blepharitis may be itchy and uncomfortable, but it will not harm vision or cause eye damage. It is not contagious.1-3

How is it caused?

There are 2 types of blepharitis:2

  • Anterior blepharitis – Inflammation along the front edge of the eyelid at the base of the eyelashes
  • Posterior blepharitis – Inflammation along the inside edge of the eyelid where the eyeball is located

Anterior blepharitis is often caused by bacteria (staphylococcal blepharitis) or dandruff (seborrheic blepharitis). The bacteria that cause staphylococcal blepharitis are normal to have on the eyelid. However, if the bacteria become too widespread, they may cause infection. The presence of mites can also cause anterior blepharitis.2

Posterior blepharitis can occur when unusual oil production blocks the small oil glands on the eyelids. The blockages allow bacteria to grow, causing infection. Skin conditions like rosacea or seborrheic dermatitis may also cause posterior blepharitis.2

Symptoms of blepharitis

Symptoms of blepharitis may be worse upon awakening. They include:1

  • Red, swollen eyelids
  • Flaking skin around the eye
  • Crusted eyelashes
  • Eyelids sticking together
  • Watery eye
  • Red eye
  • Gritty, burning, or stinging feeling in the eye
  • A greasy look to the eye
  • Frequent blinking
  • Light sensitivity
  • Blurry vision which gets better after blinking

How is blepharitis linked to chronic dry eye?

The tear film helps keep the eye lubricated. This is the layer of fluid that covers the surface of the eye. It is made up 3 different layers:1,4

  • An oily (lipid) layer on the outside
  • A watery (aqueous) layer in the middle
  • A mucus (mucin) layer on the inside

The oily layer helps prevent tears from evaporating. When the oil glands of the eyelid are not working correctly, the tear film may evaporate faster than it should. This will lead to symptoms of dry eye.1,4

Any debris that is on the eyelid, such as oily crusting or dandruff, may make its way into the tear film. This can also interfere with the tear film’s ability to fully lubricate the eye, causing dry eye.1,4

Ways to manage blepharitis

Blepharitis generally does not completely disappear. It may be a chronic condition which will flare up from time to time. There are both at-home and in-office treatments for blepharitis. An eye doctor can determine which is the best treatment after a complete eye exam.1,5

Eyelid scrubs are often the first course of treatment. Some products can loosen crusting and remove bacteria to relieve symptoms, such as:1,5

  • Prescription eyelid cleanser
  • Non-prescription eyelid wipes
  • Diluted baby shampoo

Warm compresses applied to the affected eye may also provide relief and speed healing.1,5

If those steps do not work, your doctor may prescribe an antibiotic to treat the bacteria or mites that are causing blepharitis. These topical medicines come in several forms, including eye drops, creams, and ointments. In rare cases when topical antibiotics do not work, your doctor may prescribe an oral antibiotic.1,5

In some cases, doctors recommend in-office procedures to treat blepharitis. These methods focus on removing bacteria or mites and opening clogged oil glands. These procedures include:1,5

Treating underlying conditions like seborrheic dermatitis or rosacea may also be part of a plan to clear up blepharitis.1,5

If you have symptoms of blepharitis or questions about its link to chronic dry eye, talk to your doctor. They can help you find the treatment that is right for you.

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