What is blepharitis?

Blepharitis is an inflammation of your eyelids. It can make eyelids and eyelashes red and 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 can be uncomfortable, but rarely causes serious eye damage.

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 just taking care with your hygiene, but you may need treatment for several months.


Why do I get blepharitis?

There are two types of blepharitis.

• Anterior blepharitis, which affects the outside front edge of your eyelids (near your eyelashes). It may be caused by an infection by staphylococcus bacteria. If it is, it is called staphylococcal blepharitis.

• Posterior blepharitis, which is caused when something affects your meibomian glands (which produce part of your tears). It may be called meibomian blepharitis.

Another reason you may get blepharitis is 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 and posterior blepharitis.

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 meibomian blepharitis tend to happen more in older people.

Staphylococcal blepharitis happens in younger people.


How will I know I have blepharitis?

Your optometrist, doctor or eye specialist can spot the signs of blepharitis by looking closely at your eyelids.

A doctor can take a swab which they can send away to be checked to see if there is a staphylococcus bacteria infection.


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

Blepharitis is a condition that tends to come back even after treatment. It is possible to make your eyes more comfortable, but blepharitis often cannot be totally cured.

If you have blepharitis, avoid eye make-up.

There are treatments which can help you reduce the effects of blepharitis. You may need the 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 use a flannel or something similar as a warm compress, or you can buy special packs from your optometrist which you heat up in the microwave. Soak the flannel (it is best to use a separate clean flannel for each eye) in hot, not boiling water, and place the flannels on the shut eyelids for five minutes, rocking gently with the heel of your hands. This will loosen the crusts. You can then use lid scrubs (see below).


2.       Lid scrubs

Make up a solution of baby shampoo (one part baby shampoo to 10 parts water) or bicarbonate of soda (one teaspoon dissolved in a cup of water) using slightly cooled boiled water. After using the warm compress, use your (clean) finger to pull your lower lid slightly away from the eye and clean the lower lid edge with a cotton wool bud, dampened in the solution you have made. You should aim for the base of the eyelashes. You can also do this with the upper lid, but it may be more tricky.

Repeat this morning and evening for two weeks. Then repeat only in the morning for two weeks, and then two to three times each week in the future to prevent the problem from coming back.

If you want to, you can buy special lid wipes or solution from your optometrist or pharmacy.


3.    Lubricants

Using an ointment on the edges of your eyelids after cleaning them can help your eyes feel more comfortable. You might find it easier to put the ointment inside your lower lid. If you have dry eyes, you can use gel or drops to lubricate them. Ask your optometrist to recommend the best type to suit your eye problem. If you use lubricants regularly, you may be able to get them on prescription.


4.    Oral antibiotics

If other treatments do not work, you may be prescribed antibiotics to take by mouth for three months. Antibiotic tablets do not suit everyone, so talk about this to someone who knows your medical history. The benefit may last for some months after you finish the treatment. If the problem comes back, you may need another course of tablets.

Other tips

Some medicines can make your eyes feel dry. Talk to your GP or pharmacist about whether this may be the case.