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Do you occasionally get redness and swelling of your eyelids? Well, you might have blepharitis.

Blepharitis is an inflammation of the eyelids; it rarely causes any disruption to your vision but can be a nuisance for daily comfort. If blepharitis is not treated properly, it can bring about other problems such as dry eyes, red eyes (conjunctivitis) and cysts, 

What's it like to have blepharitis?

clubtable, Public domain, via Wikimedia Commons

Symptoms of blepharitis include:

  • sore eyelids

  • itchy eyes

  • a gritty feeling in the eyes

  • flakes or crusts around the roots of the eyelashes

  • red eyes or eyelids

  • eyelids sticking together in the morning when you wake up

For some people, these symptoms are intermittent – meaning they can worsen and improve over a long period of time.

Types of blepharitis

There are two types of blepharitis, each with different causes. 

Posterior blepharitis

Posterior blepharitis is the more common type of blepharitis. People with the posterior type usually develop inflammation of the inner portion of the eyelid at the level of the meibomian glands. Hence, posterior blepharitis is caused by the dysfunction of meibomian glands. The meibomian gland is a gland that lines across our eye lid, whose function is to secrete oily components of the tears, thereby lubricating our eyes.

Image credit to American Academy of Ophthalmology

People who have certain skin conditions, such as rosacea and seborrhea (redness, scaly patches and itching mostly on the scalp, e.g. dandruff), are more likely to develop blepharitis, especially the posterior kind.

Anterior blepharitis

On the other hand, anterior blepharitis primarily affects the base of the eyelids. It’s usually caused by bacterial infection, particularly Staphylococcus aureus and coagulase-negative staphylococci. These bacteria change the secretions of meibomian gland either through direct infection of the lids, production of exotoxin or causing an allergic response.

Anterior blepharitis.Crusting at the base of the lashes is shown in this image of a patient with seborrheic blepharitis.

Nevertheless, it’s not uncommon to see people having overlapping symptoms of both types of blepharitis.

Treatment of blepharitis

A must-do for all patients suffering from blepharitis is to practise good eyelid hygiene:

  • Wash your eyelids – Wash your hands first. Use plain warm water or warm water with a drop of baby shampoo (1:10 of dilution ratio) on a clean washcloth, gauze pad, or cotton swab. Do not use regular shampoo as it may irritate the eyes. Then, use the wet cloth to gently clean any crusty material off the eyelashes and eyelids. You may also purchase over-the-counter eyelid cleansing wipes at any pharmacy.

  • Avoid using eye makeup until symptoms subside.

  • Discard and replace all eye makeup to eliminate the possibility that your cosmetics are infested with bacteria or mites.

  • Temporarily discontinue wearing contact lenses during treatment

There are also things you can do to relieve the discomforts on the eyelids:

  • Warm compress on eyes – Wet a clean washcloth with warm (not scalding hot) water and put it over your eyes. When the wash cloth cools, reheat it with warm water and put it back over your eyes. You may do this for 5 to 10 minutes once or twice daily.

  • Gently massage your eyelids – Do this right after putting warm, wet pressure on your eyes. Use the washcloth or a clean fingertip to gently rub your eyelid in small circles.

In some cases, blepharitis may call for the following treatments, which you may purchase from a healthcare professional:

  • Artificial tears – Dry eyes are quite common with blepharitis. Artificial eye drops can be used to relieve dry eyes.

  • Antibiotic eye drop/ eye ointment – if there are signs of bacterial infection in the eyes

  • Oral antibiotics – For severe cases of blepharitis that do not seem to respond to the treatments we have mentioned. Oral antibiotics are strictly available via a doctor's prescription only.

A word from Doc2Us

If you have any questions related to blepharitis, you can consult our professional doctors and healthcare professionals on Doc2Us. Doc2Us is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.

Download Doc2Us app on Apple App Store, Google Play Store and Huawei App Gallery; or use our web chat at https://web.doc2us.com/

Note: Doc2Us is not for medical emergencies. In the event of urgent medical conditions, please call 999.

Disclaimer: As a service to our users and general public, Doc2Us provides health education contents. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

References

  1. Rutter P. Community Pharmacy: Symptoms, Diagnosis and Treatment. 5th ed. 2020.

  2. UpToDate - Blepharitis

  3. Lindsley K, Matsumura S, Hatef E, Akpek E. Interventions for chronic blepharitis. Cochrane Database of Systematic Reviews. 2012.

Cover image credit: clubtable, Public domain, via Wikimedia Commons

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Written By

Ms Joyce Toh

Reviewed By

Doc2us Medical Board

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