Treating Blepharitis


Blepharitis is an inflammation of your eyelids. It can make eyelids red and eyelashes crusty and make your eyes feel irritated or itchy.

It can also lead to burning, soreness or stinging in your eyes. In severe cases, your lashes may fall out, and you can develop small ulcers or styes as well. You may find your eyelids become puffy. The symptoms tend to be worse in the morning and when you wake up you may find your lids are stuck together.

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.

Causes of blepharitis

The causes of blepharitis depends on the type of blepharitis contracted. There are two types of blepharitis.

Anterior blepharitis – this affects the outside front edge of your eyelids (near or among your eyelashes). It may be caused by an infection by staphylococcus bacteria.

Posterior blepharitis – this is also called Meibomian gland dysfunction (MGD). MGD is caused when something affects the inside rim of your eyelids, just behind your eyelashes, which contains your Meibomian glands. Your Meibomian glands produce part of your tears.

You may also got blepharitis as a complication of seborrhoeic dermatitis, which makes your skin inflamed or flaky. This can involve the scalp (when it is called dandruff), lashes, ears and eyebrows. Seborrhoeic dermatitis can cause both anterior blepharitis and MGD.

Who is at risk of blepharitis?

Blepharitis is more common in people over 50, but it can develop at any age. As you get older, the glands in your eyelids that secrete part of your tears become blocked more easily. Your tears contain fewer lubricants and your eyes can feel gritty and dry, so seborrhoeic blepharitis and MGD tend to happen more in older people.

How will I know I have blepharitis?

Your optometrist, GP or eye specialist can spot the signs of blepharitis by looking closely at your eyelids. A doctor may decide to take a swab which can be sent away to be checked for a bacterial infection.

How should I look after my eyes if I have blepharitis?

It is possible to make your eyes more comfortable, but blepharitis often cannot be totally cured. If you have blepharitis, avoid eye make-up and smoky atmospheres.

There are treatments which can help you reduce the effects of blepharitis. You may need treatment for several months.

1. Warm compresses

Warm compresses work by warming the material that blocks the glands and loosening the crusts on the eyelid. This makes them easier to remove. You can buy reusable warming packs which you heat up in the microwave from your optometrist. Alternatively you can use a flannel, cotton-wool ball or something similar as a warm compress. Soak the compress in hot, but not boiling, water and place it on edge of your closed eyelids for five minutes, rocking it gently. This will loosen the crusts. You can then clean your lids. You should use a separate clean compress for each eye.

2. Lid Cleaning

What should I use?
You can buy special lid wipes or solution. Your optometrist will be able to advise you on this. Or, you can fill a clean egg cup with boiling water that has cooled. Then add either baby shampoo (one part baby shampoo to 10 parts water) or a quarter of a teaspoon of bicarbonate of soda (not baking powder).

What should I do?
Use a lid-cleaning wipe or a cotton-wool bud dampened in the solution you have made (squeeze it out first) to gently clean the edges of your eyelids near your lashes. Wipe from the inside (near your nose) to the outside corner of your eye. Be careful not to clean inside your eyelid or to touch the surface of your eye with the wipe or cotton-wool bud.

Repeat this twice a day at first and reduce this to once a day as the condition improves.

3. Antibiotics

If these treatments do not work, your doctor or prescribing optometrist may prescribe you antibiotic ointment or tablets. Your prescriber will tell you how long to use these for, but if you need to take antibiotic tablets you may need to take these for several weeks or months. Your doctor or prescribing optometrist will discuss with you whether they are suitable for you. The benefits may last for some months after you finish the treatment.