Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Blepharitis is an inflammation of the eyelid that tends to recur. It is a common eye disorder that can affect the skin, lashes, or glands of the eyelid.

Blepharitis is classified as:

  • Anterior blepharitis—mainly affect front edge of the eyelid where the eyelashes attach
  • Posterior blepharitis—inner edge of eyelid

Blepharitis may also be a combination of these 2 types.

Blepharitis

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Causes

It is not always clear what causes blepharitis. There are a number of factors that may be linked to the development of blepharitis based on the type:

  • Anterior blepharitis—common causes include bacterial infection, allergic reaction to toxins from bacteria, and/or skin condition called seborrheic dermatitis
  • Posterior blepharitis—often caused by gland dysfunction

Other general issue that may play a role in blepharitis include:

  • Allergic reaction to normal skin bacteria
  • Atopic or contact dermatitis
  • Acne rosacea
  • Reaction to certain medications like isotretinoin or antihistamines
  • Infections—most often bacterial but can be viral, parasitic, or fungal

Risk Factors

Factors that may increase your chance of blepharitis include:

  • Dry eye
  • Giant papillary conjunctivitis

Factors that can make symptoms worse include:

  • Contact lenses
  • Exposure to smoke or allergens
  • Alcohol consumption
  • Eye makeup—especially if it is left on overnight
  • Use of retinoids—can be found in skin creams or medications

Symptoms

Symptoms can vary but are usually worse in the morning and involve both eyes. If glands are affected they can reduce the amount of moisture for the eye. Blepharitis can cause one or more of the following:

  • Sore eyelids
  • Dry eyes or excess watering
  • Burning or feeling of grit in the eyes
  • Redness, flaky skin, and oily secretions along the edge of the eyelid
  • Light sensitivity
  • Crusty material clinging to the eyelashes, eyelids feel glued together in the morning

More severe blepharitis can cause:

  • Blurring of vision
  • Missing eyelashes
  • Ulcers or sores at the base of the eyelashes (in severe cases)

Diagnosis

You will be asked about your symptoms and medical history. An examination of your eyes will be done. Blepharitis may be suspected based on the symptoms.

If inflammation is severe, occurs often, or is not responding to treatment further tests may be needed. This may include:

  • Culture—to look for bacteria, viruses, or fungus that may be present
  • Biopsy—sample of tissue from eyelid is examined under a microscope to look for any abnormalities

Treatment

Blepharitis tends to reappear but treatment can help manage symptoms. Managing symptoms can help reduce the chance of complications.

Cleaning and caring for the eyelids is important during flare ups. Simple home steps like warm compresses to the eye and gentle cleaning will help remove crust. Massage and applying pressure to the eyelids can also help release fluids from gland.

Other steps like avoiding use of contacts or eye makeup may also be needed until symptoms disappear.

Blepharitis that does not respond to self care may need medication. Options will depend on specific symptoms but may include:

  • Topical antibiotics—applied directly to eyelid or eye
  • Topical corticosteroids—may help with severe inflammation
  • Oral antibiotics—for blepharitis that does not respond to topical treatment, rare option

Prevention

There are no known ways reduce your chance of blepharitis since the cause is not clear.