Everything about blepharitis

Blepharitis is a common inflammatory condition and affects the edge of the eyelid. It refers to that point where the eyelashes grow.

Blepharitis is a chronic condition that is often treatable. It usually does not cause permanent damage to your vision and is not contagious.

What causes blepharitis?

Blepharitis usually occurs when tiny sebaceous glands, which are located near the base of the eyelashes, become blocked. This leads to inflammation near the eyes and they become irritated. Bacteria normally live on the surface of the skin around the eyes, but in some people they start to grow inside the skin at the base of the eyelashes.

The ensuing irritation is sometimes associated with hyperfunction of the adjacent sebaceous glands. It causes dandruff-like scaling and crusting along the eyelashes and edge of the eyelid as well as callous, painful inflamed bumps inside the eyelids.

There are various possible diseases or conditions that can cause blepharitis such as germs, allergies, increased secretion of sebum from the glands of the eyelids as well as insufficient hygiene.

What are the causes of blepharitis?

The exact cause of blepharitis is not clear as it may be linked to one or more factors. They are:

  • Seborrheic dermatitis. It looks like dandruff of the scalp and eyebrows,
  • Bacterial infection.
  • Sebaceous glands. Glands in your eyelids that are either blocked or malfunctioning.
  • Rosacea. A skin condition characterized by redness of the face.
  • Allergies. This includes allergic reactions to medications you use for your eyes, contact lens solutions, or even eye makeup.
  • Mites, or lice on the eyelashes.

How many and what types of blepharitis are there?

There are 3 main types / forms of blepharitis:

  1. The anterior microbial. It usually affects young people. It has sticky secretions and when waking up in the morning the eyelids are difficult to open, because they are usually stuck.
  2. Anterior seborrhea. It looks like dandruff. It affects older people and can coexist with seborrheic dermatitis of the face or scalp.
  3. Posterior blepharitis. It is characterized by chronic irritation of the eyelids and dry eyes. It can coexist with rosacea or seborrheic dermatitis.
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What are the symptoms of blepharitis?

  • Wet eyes.
  • Tearing.
  • Red eyes.
  • Burning or stinging in the eyes.
  • Eyelids more oily and irritated than normal.
  • Itchy eyelids.
  • Redness on the eyelids.
  • Swollen eyelids.
  • Exfoliation of the skin around the eyes.
  • Creation of a “crust” on the eyelashes after sleep.
  • Eyelids that stick together.
  • The person suffering from blepharitis needs to blink their eyes more often.
  • Photosensitivity.
  • Eyelashes that grow unnaturally and in the wrong direction.
  • Drooping and perhaps loss of eyelashes.


  • Blepharitis usually affects the two eyes. You will often notice a sticky discharge at the roots of the eyelashes. Scaling on the eyelids, something like dandruff and greasy or waxy crusts.
  • In chronic conditions loss of eyelashes may even be observed or hailstones or corns may appear at regular intervals.
  • Because the symptoms are similar to hers conjunctivitisthere may be confusion. But there is also the possibility of coexistence, so in this case we are talking about blepharoconjunctivitis. This usually occurs in people who have oily skin, dandruff or suffer from dry eyes.

What is blepharitis related to?

  • Rosacea. In certain people, a dermatological condition, rosacea, coexists. In it, visibly dilated microvessels are observed on the face and especially on the nose. In these cases, the blepharitis is more persistent and there is a high chance that medication will be needed.
  • Hail or hailstones. When the Meibomian glands malfunction and are functionally blocked, then there is the possibility of developing an inflammatory reaction to their thick secretion. This reaction may well develop into a painful red mass on the eyelid, which is called a cataract.
  • Corneal opacities. The cornea is the clear front part of the eye, which covers the iris, pupil and anterior chamber. Constant irritation from the inflamed eyelids can lead to white round opacities where the eyelids touch the cornea with the eye open. It can also cause neovascularization with consequent opacification. We would say that this is not a common case, rather we would call it rare. Your eye doctor will decide whether to give you an ointment or some cortisone eye drops.

How can you treat blepharitis?

Blepharitis is a condition that may not be completely cured. But it can be controlled with a few simple daily measures when it is in full swing.

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Depending on the type of blepharitis you have, your eye doctor may recommend:

  • Warm pads (compresses).
  • Proper hygiene and light eyelid massage.
  • Pharmaceutical / local antibiotic treatment.


  • At least twice a day, wet a clean towel with warm, not hot water or chamomile. After you’ve squeezed your cloth well, place it over your closed eyelids for one to three minutes. When it starts to lose its temperature, wet it an additional two or three times. This will help liquefy the oily secretions from the sebaceous glands of the eyelids and help prevent the development of the inflammatory nodule within the sebaceous gland of the eyelid. Consequently it helps prevent quartz growth. At the same time it will soften and relax the peeling and secretions.
  • Get a massage on the eyelids after applying the warm compress. Massage helps stabilize the tear film in the eye. Massage the upper and lower eyelid towards the eye, neither too loose nor too strong. It would be beneficial to do 5 to 10 repetitions for about 30 seconds immediately after applying the heat. Be careful not to damage your eye under closed lids!
  • Light wash of eyelashesand caution not to wash the eye with Baby Shampoo. It would be good to dilute one drop of Baby Shampoo in ten drops of water.
  • Azyter Eye Drops. It is an antibiotic (azithromycin), which helps with blepharitis. Several people have complained that their eyes sting during instillation. It is taken for one week initially and may need to be repeated monthly.
  • Ointment at night type Tobradex. This is a combination of antibiotic and cortisone ointment. Recommended if other measures are not sufficient and only for limited use. Or for those cases where the ophthalmologist considers that the microbial element needs treatment. Prolonged use, exceeding one month of corticosteroids can cause glaucoma in many predisposed individuals. Your ophthalmologist will of course make this decision for you.

Using cortisone without the supervision of an ophthalmologist can lead to irreversible damage to the optic nerve due to glaucoma.

How can you relieve the symptoms of blepharitis?

Simple, daily hygiene measures could reduce the number of additional medications needed to control blepharitis and its symptoms.

  • Artificial tears. They can be used to relieve the symptoms of dry eye. They are drops that you get without a prescription. Preservative-free ones are recommended.
  • Omega-3 fatty acids. They have been shown to help with blepharitis and dry eye in general. You take them as dietary supplements, or as a diet with omega-3 rich fish or flaxseed.
  • Antibiotics. They are obtained by prescription and can reduce the bacterial content of the eyelids.
  • Oral administration Vibramycin or Minocycline for the systematic treatment of both severe blepharitis and rosacea. In general, Doxycycline or Minocycline is preferable, which do not have restrictions on administration with meals. Pregnancy is a serious contraindication for the administration of the above drugs. They can cause disorders in embryogenesis in teeth and bones.
  • Those with rosacea can also see improvement in their facial skin by using one salve metronidazole (Rombaz) twice a day.
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Relief from the daily discomfort caused by blepharitis is possible in most cases, as long as you follow your eye doctor’s instructions to the letter!

Pharmaceutical preparations may not be sufficient as a treatment.

Applying a heat compress, carefully cleaning and caring for your eyelashes on a daily basis is the common secret to controlling blepharitis.

Why are regular eye exams important for everyone?

Blepharitis is one of the most familiar, common and persistent inflammations of the eyelids. Symptoms include increased sensitivity, itching and redness of the eye. People who have a tendency to have oily skin, dandruff or dry eyes have a “tendency” to this condition.

Blepharitis can begin in early childhood with the appearance of granulation on the eyelids and continue throughout life as a chronic condition. But it can also appear later.

In blepharitis, both eyelids are covered by an oily discharge and bacteria near the base of the eyelashes. The eye suffers from inflammation and externally it seems to be quite irritated.

Eye diseases can occur at any time and at any age. Many of them do not warn you and do not inform you with symptoms before the disease has already caused a noticeable damage.

The news is encouraging, as in most cases your vision loss can be prevented if the condition is diagnosed and treated early.

It would be good not to neglect medical examinations by an ophthalmologist at regular intervals.

The information in our articles is not intended to replace a relationship with a qualified healthcare professional, physician or medical advisor, and is not intended as medical advice.

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