Blepharitis

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What is blepharitis?

Blepharitis is an inflammation of the eyelash follicles and the skin along the eyelid margin. In blepharitis, the eyelid margins become swollen, flaky and scaly. This disease results from an excess growth of bacteria that are normally found on the eyelids. This growth generally occurs because of an overabundance of oil produced by the glands near the eyelids. 

Normally, the oil becomes the outer layer of the healthy tear film and prevents its rapid evaporation. As a result of the interplay between eyelids and the eyeball, chronic blepharitis, eye discomfort, and decreased vision often occur together.

Blepharitis can also develop because of the presence of mites at the base of the eyelashes. People with skin conditions such as rosacea or seborrheic dermatitis are more prone to blepharitis.

If you have blepharitis, your eyes may feel itchy, gritty, sore or burning. Other symptoms of blepharitis include crusting on the eyelid margins and redness, swelling, watering or discharge from the eyes. This discharge may cause your eyelashes or even your eyelids to feel stuck together when you awaken.

Blepharitis may be mistaken for other eye (ocular) disorders, such as conjunctivitis or a stye or chalazion (small bump in the eyelid caused by a blockage of a tiny oil gland). Blepharitis typically affects all four eyelids.

Only your health care provider can properly diagnosis blepharitis. If you suspect you have blepharitis, seek prompt medical attention. Blepharitis treatment usually involves application of warm, damp compresses and cleansing of the eyelid area to remove excess skin oils. In some cases, your health care provider may prescribe an antibiotic ointment. Left untreated, blepharitis can become a chronic condition and lead to loss of eyelashes, as well as more serious eye diseases such as corneal ulcers.

Seek immediate medical care (call 911) if you, or someone you are with, have bleeding from the eyes, severe eye pain, sudden changes in vision, or sudden increase in sensitivity to light.

What are the symptoms of blepharitis?

Blepharitis symptoms include eyelids that become swollen, flaky and scaly. These symptoms arise because the eyelash follicles are inflamed. You may also experience burning eyes and scaly skin at the base of your eyelashes.

Ocular symptoms of blepharitis

Blepharitis may accompany other symptoms related to the eyes including:

  • Crusting of the eyelid margin
  • Discharge from the eyes
  • Dry eyes
  • Excessive eyelid debris (scurf)
  • Eyelashes that are stuck together when you awaken
  • Gritty feeling in the eyes
  • Itchy eyes
  • Loss of eyelashes
  • Red, sore eyes (bloodshot eyes)
  • Watery eyes

Symptoms that might indicate a serious condition

Seek immediate medical care (call 911) if you, or someone you are with, have blepharitis along with other serious symptoms including:

  • Bleeding from the eye
  • Sudden change in vision, loss of vision, or eye pain
  • Sudden increase in sensitivity to light

What causes blepharitis?

Blepharitis is caused by inflammation of the eyelash follicles in your eyelids. This disease results from an excess growth of the bacteria that are normally found on the eyelids. This growth generally occurs because of an excess accumulation of oil and cellular debris produced from clogged glands near the eyelids. Blepharitis also can develop because of the presence of mites at the base of the eyelashes. People with skin conditions such as rosacea or seborrheic dermatitis are more prone to blepharitis.

What are the risk factors for blepharitis?

A number of factors increase the risk of developing blepharitis. Not all people with risk factors will get blepharitis. Risk factors for blepharitis include:

Reducing your risk of blepharitis

You may be able to lower your risk of blepharitis by:

  • Applying warm, damp compresses on your eyes to loosen oil and crusts on the eyelid margins

  • Gently cleaning the eyelids twice daily with a washcloth and warm water

How is blepharitis treated?

Treatment of blepharitis begins with seeking medical care from your health care provider. The mainstay of blepharitis treatment is good eyelid hygiene, usually through the application of warm, damp compresses several times a day. Your health care provider may suggest using an eyelid scrubbing solution made from very dilute baby shampoo. In addition, your health care provider may prescribe an antibiotic ointment to address excess bacterial growth on your eyelash follicles. In cases of severe inflammation, topical corticosteroids may also be prescribed.

Blepharitis is a lid hygiene problem. Symptoms of blepharitis can be managed successfully, but the condition may recur.

What are the potential complications of blepharitis?

Left untreated, blepharitis can result in eye infections because of the constant irritation of the eye surface. It can lead to corneal ulcers or, in extreme cases, blindness in the affected eye. You can help minimize your risk of serious complications from blepharitis by following the treatment plan you and your health care provider design specifically for you. If your blepharitis symptoms do not improve or become worse, seek immediate medical care. Complications of blepharitis include:

  • Chalazion (inflammation of a blocked oil gland in the eyelid margin)

  • Chronic dry eyes (evaporative dry eye syndrome)

  • Conjunctivitis (inflammation of the eye surface)

  • Corneal abrasion, ulcer or scarring

  • Eyelid misdirection (ectropion/entropion)

  • Loss of eyelashes

  • Periorbital cellulitis (infection of the eyelids or other soft tissue around the eyes)

  • Scarring of the eyelids

  • Stye or hordeolum (localized bacterial infections of an oil gland or eyelash follicle in the eyelid margin)

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 16
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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  2. Eye Problems. FamilyDoctor.org. https://familydoctor.org/symptom/eye-problems/
  3. Lindsley K, Matsumura S, Hatef E, Akpek EK. Interventions for chronic blepharitis. Cochrane Database Syst Rev 2012; 5:CD005556.