July 20, 2024

If you’ve ever experienced itchy, red eyes with crusts or flakes around the eyelids, it’s possible you were dealing with blepharitis. Blepharitis is a common condition that can affect both children and adults. It is characterized by chronic inflammation of the eyelids, typically affecting the part of the eyelid where your eyelashes grow. Although blepharitis can be uncomfortable, it can generally be treated quickly and is not contagious.

Eye care doctors, such as optometrists or ophthalmologists, can diagnose and treat blepharitis. If you think you might have blepharitis, you can ask your healthcare provider for a referral to an eye care specialist. Through a comprehensive eye exam, they can identify the cause of your symptoms and recommend a course of treatment.

There are two types of blepharitis, which are defined by the area of the eye that is affected and what caused it. You can have one or both types at the same time. The types are:

  • Anterior blepharitis affects the portion of your eye where your eyelashes connect to your eyelid. Common causes of this type include a bacterial infection, seborrheic dermatitis (dandruff), and a combination of these two causes.
  • Posterior blepharitis affects the part of your eyelid that touches your eye. Common causes of this type include rosacea and meibomian gland dysfunction (MGD), which is characterized by poor functioning of the tiny oil glands in your eye called the meibomian glands.

Blepharitis symptoms and their severity can vary from person to person. If you have blepharitis, you may experience any of the following symptoms in or around your eyes:

  • Stinging or burning
  • Watering or creating tears
  • Itchiness
  • Sensitivity to light
  • Redness
  • Swelling
  • Dryness
  • Feeling like there’s something in your eye
  • Crustiness or dandruff-like flakes on them, especially when you wake up
  • Foamy tears (tears with small bubbles)

Over time, if blepharitis is untreated, it can lead to more severe symptoms, including:

  • Blurry vision
  • Eyelashes falling out
  • Eyelashes growing in the wrong direction
  • Swelling in the eye, such as in the cornea (the outermost layer of your eye)

We know of a few causes of blepharitis at this time, and researchers are still studying other potential causes. Most cases—particularly anterior blepharitis cases—are caused by having too much bacteria (such as staphylococcus) at the base of your eyelashes. It’s normal to have bacteria on your skin, but if it grows too much in this area, it can cause blepharitis. 

It’s also possible to develop blepharitis if:

  • Your eyelid oil glands (the meibomian glands) are clogged or irritated
  • A type of face mite called a Demodex lives in your eyelash follicles
  • Your eyelids produce less oil than average

Risk Factors

You may be more likely to develop blepharitis if you also experience:

  • Seborrheic dermatitis (dandruff), a type of eczema that primarily affects the oil (sebaceous) glands
  • Rosacea, a chronic skin condition that causes areas of red, inflamed skin
  • Allergies that affect your eyelashes

People with oily skin may also find that they are more prone to developing blepharitis than those with dryer skin types.

To determine if your eye condition is blepharitis, it’s best to seek care from an eye care specialist. They can perform a comprehensive eye exam in which they use special instruments, such as a light and a magnifying tool, to test your eyes and take a closer look at your eyelids and eyelashes. 

Your eye care specialist may also ask about your health history and other medical conditions you have, to determine what might be causing your symptoms. They may also perform tests to identify the quality of your tears. If they determine that blepharitis is the cause of your symptoms, your eye care specialist can use the eye exam to tell you the type of blepharitis you have and recommend appropriate treatment options based on the type and its cause.

In treating blepharitis, it’s important to manage both the symptoms and the ongoing treatment of any underlying causes. Your eye care specialist can recommend a comprehensive course of treatment, which may include a combination of eye hygiene and prescription medication.

Eye Hygiene

The most effective way to reduce instances of blepharitis—and prevent recurrence—is through a daily routine of cleaning your eyelids. This can involve the following:

  • Make sure to clean your eyelids every day with water and a face cleanser, or baby shampoo.
  • If the crusts on your eyes are stubborn, warm compresses can help loosen them.
  • If your oil glands are clogged, you can try to massage your eyelids to help move the oil out.
  • You may want to avoid wearing eye makeup while seeking treatment, to make it easier to keep your eyes clean.

Prescription Medication

For certain kinds of blepharitis, prescription medication may be necessary. This may include:

  • If your eyes are very swollen, red, or irritated, your eye care specialist might prescribe eye drops with steroids. If you don’t need steroids, they may recommend you try artificial tears, a common type of eye drop found over the counter.
  • If your blepharitis is caused by bacteria, your eye care specialist may prescribe antibiotic eye drops, pills, or ointments.
  • To treat underlying conditions such as rosacea or dandruff, your healthcare provider may prescribe medication or special skincare or hair products. 

Although blepharitis is common and can be treated, there’s a good chance it will come back. Make sure to keep up with your eye hygiene practice and continue to treat any underlying conditions.

It’s important to maintain proper eye hygiene to help prevent blepharitis flare-ups.

If you are diagnosed with blepharitis, make sure to speak with your eye care specialist about what causes your blepharitis, and continue to prevent the root cause as needed. For example, if you typically experience blepharitis related to bacterial infections, your provider may prescribe you medication to reduce the flare-ups.

If blepharitis is left untreated, it can lead to other issues, particularly with your eyes. The following issues may occur:

  • Styes, or red bumps on the eyelid resulting from clogged oil glands
  • Chalazions, or lumps on the eyelid from a stye that hasn’t gone away
  • Dry eye
  • Damage to your cornea due to swelling or eyelashes growing in the wrong direction
  • Redness in your eyes that lasts for a long time

Blepharitis, a common eye condition that can cause irritation, redness, and itchiness, is often characterized by the flaky crusts it produces on the eyelids. It can be caused by a variety of factors, from bacteria to clogged oil glands to underlying conditions such as rosacea.

Although common, blepharitis can be a difficult condition to manage. It’s important to develop a treatment plan with an eye care specialist to reduce your symptoms and prevent future severe occurrences. Maintaining good eye hygiene and addressing underlying causes can help you manage your blepharitis.

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