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What is blepharitis?

Blepharitis is an inflammation of your eyelids. It can make your eyelids red and eyelashes crusty and make your eyes feel irritated or sore. It can also lead to burning, itching or stinging in your eyes. The condition is not usually serious, but can lead to other problems, such as styes, ulcers and conjunctivitis if it’s not treated. You may find your eyelids become puffy. The symptoms tend to be worse in the morning and when you wake up.

Blepharitis is a chronic (long-term) condition. This means that once you have had it, it can come back even after it has cleared up. It normally affects both eyes. You can usually treat it by keeping your eyelids clean. You may need to do this for several months, or need ongoing treatment to make your eyes comfortable.

Types of blepharitis

  • Anterior blepharitis – This affects the outside front edge of your eyelids (near or among your eyelashes). It may be caused by bacteria called staphylococcus.
  • Posterior blepharitis – This is also called meibomian gland dysfunction (MGD). MGD is caused when the meibomian glands on the inside edge of your eyelids, just behind your eyelashes, are affected. Normally they release a fluid that forms part of your tear film that covers your eyes. In MGD, this fluid thickens and blocks the opening of the glands.

Sometimes, anterior blepharitis and MGD occur together. This is called mixed blepharitis.

Blepharitis is a chronic (long-term) condition. This means that once you have had it, it can come back, even after it has cleared up.

Who is at risk of blepharitis?

Blepharitis is more common in people aged over 50, but it can develop at any age. As you get older, the meibomian glands in your eyelids become blocked more easily, and your eyes can feel gritty and dry. This means that older people are more likely to have blepharitis.

You are more likely to develop blepharitis if you have:

  • a skin condition called rosacea
  • a skin condition called seborrhoeic dermatitis. This makes your skin oily, inflamed or flaky. It can affect the scalp (dandruff), eyelashes, ears and eyebrows.
  • an infestation of eyelashes, or
  • worn contact lenses for many years.

What are the symptoms of blepharitis?

The symptoms tend to be worse in the morning and you may find your lids are stuck together when you wake up. Other symptoms include:

  • itchy, sore and red eyelids that stick together
  • crusty or greasy eyelashes
  • irritated or burning eyes
  • puffy eyelids
  • finding contact lenses uncomfortable to wear
  • loss of eyelashes
  • small ulcers and styes, in severe cases.

How do you treat blepharitis?

It is possible to make your eyes more comfortable but in most cases blepharitis cannot be fully cured.

If you have blepharitis, you should avoid smoky atmospheres and eye make-up, such as eyeliner and mascara.

Warm compresses

These work by melting the blocked material in the meibomian glands and loosening the crusts on the eyelid. This makes them easier to remove. Warm compresses come in a variety of forms, such as a warming pad or pack that heats in the microwave.

Warm compresses can be made at home – soak a clean flannel, cotton-wool ball or something similar in hot (not boiling) water and squeeze off the excess. Whichever warm compress you use, place it on the edge of your closed eyelids for around five minutes. While on the eyelids, gently rock or massage the warm compress. This will soften the material in the glands and loosen the crusts. You can then clean your lids.

You should use a separate clean compress for each eye.

Lid cleaning

There are different ways of cleaning your eyelids to remove the crusts from your eyelashes. Your optometrist will be able to advise you on which option is suitable for you.

Gently clean the edges of your eyelids near your lashes. Wipe from the inside (near your nose) to the outside corner of your eye. You can try to
clean behind the lashes (the meibomian glands), but not the inside edge, by gently pulling away the eyelids from the eye. Repeat this twice a day at first and reduce this to once a day as the condition improves. You may need special cleaning treatments to help remove crusts or infestations from your eyelids and lashes. Your optometrist or eye doctor will tell you if these are suitable for you.

Antibiotics

If warm compresses and cleaning do not work, your optometrist or eye doctor may prescribe antibiotic ointment or tablets. They will tell you how long to use these for. If you need to take antibiotic tablets you may need to take these for several weeks or months and the benefits may last for some months after you finish the treatment.

Last reviewed: November 2024