Quick answer
Blepharitis is a very common condition in which the eyelid margins become chronically inflamed, causing irritation, redness and crusting. It affects people of all ages and tends to recur. Although rarely sight-threatening, it causes significant discomfort and is closely linked to dry eye disease, with treatment focused on controlling symptoms through good lid hygiene.
What is Blepharitis?
Blepharitis is a very common condition in which the eyelid margins become chronically inflamed. It affects people of all ages and is one of the most frequent reasons patients attend an eye clinic. Although blepharitis is rarely sight-threatening, it causes significant discomfort and tends to recur. It is closely linked to dry eye disease — the two conditions frequently co-exist and exacerbate each other. Treatment focuses on controlling symptoms through good lid hygiene.
What are the symptoms of Blepharitis?
- Red, itchy, or burning eyelid margins
- Crusting or flaking at the base of the eyelashes, particularly on waking
- Sticky eyes on waking
- A gritty, sandy sensation in the eyes
- Temporary blurring of vision that improves with blinking
- Sensitivity to light
What causes Blepharitis?
- Anterior blepharitis — staphylococcal bacteria on the lid margin; seborrhoeic dermatitis
- Posterior (meibomian gland) blepharitis — dysfunction of the meibomian oil glands in the lid margins, causing evaporative dry eye
- Demodex mites — microscopic mites living in the eyelash follicles
How is Blepharitis diagnosed?
Clinical examination of the eyelid margins with a slit-lamp microscope. The pattern of inflammation, type of crusting, and meibomian gland expressibility guide the assessment.
How is Blepharitis treated?
Daily warm compresses (heated eye mask for 10 minutes) to loosen and express meibomian secretions, followed by lid margin scrubs (specialist wipes or dilute baby shampoo). Topical antibiotic ointment for bacterial blepharitis. Oral tetracyclines (doxycycline) for severe meibomian gland disease. Lubricating eye drops for co-existing dry eye.
Frequently asked questions
How often should I clean my eyelids for blepharitis?
During a flare, clean lids twice daily. Once symptoms settle, many people maintain control with once-daily hygiene. Consistency matters more than occasional intensive cleaning.
What are the symptoms of blepharitis?
Blepharitis causes red, itchy or burning eyelid margins, with crusting or flaking at the base of the eyelashes, particularly on waking. Patients may notice sticky eyes on waking, a gritty, sandy sensation, sensitivity to light, and temporary blurring of vision that improves with blinking.
What causes blepharitis?
Blepharitis has several causes. Anterior blepharitis stems from staphylococcal bacteria on the lid margin or seborrhoeic dermatitis. Posterior blepharitis involves dysfunction of the meibomian oil glands, causing evaporative dry eye. It can also result from Demodex mites, microscopic mites living in the eyelash follicles.
How is blepharitis treated?
Treatment focuses on lid hygiene. Daily warm compresses (a heated eye mask for 10 minutes) loosen and express meibomian secretions, followed by lid margin scrubs using specialist wipes or dilute baby shampoo. Topical antibiotic ointment, oral tetracyclines for severe gland disease, and lubricating eye drops may also be used.
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