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Blepharitis

How to Say It: Bleff-uh-REYE-tis

Definition

Blepharitis is inflammation of the eyelids. It can affect the skin, lashes, or glands of the eyelid.

There are two types:

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

A person may also have a mix of both types.

Blepharitis
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Causes

Anterior blepharitis is usually caused by a skin condition called seborrheic dermatitis. Posterior blepharitis is usually caused by problems with the glands of the eyelids.

Other things that may play a role are:

  • Allergic disorders, such as atopic or contact dermatitis
  • Skin disorders, such as rosacea and psoriasis
  • A reaction to certain medicines, such as isotretinoin or antihistamines
  • Viral, parasitic, or fungal infections
  • Problems with the immune system
  • A history of eye trauma

In some people, the cause is not clear.

Risk Factors

Things that may raise the risk of this problem are:

  • Dry eye
  • Giant papillary conjunctivitis

Some things that may make problems worse are:

  • Contact lenses
  • Exposure to smoke or allergens
  • Low humidity
  • Retinoid creams or medicines
  • Alcohol consumption
  • Eye makeup

Symptoms

Symptoms vary from person to person. Problem happen more often in the morning. They also happen in both eyes.

Problems may be:

  • Sore, irritated eyelids
  • Dry or watery eyes
  • Itching, burning, or a feeling of grit in the eyes
  • Excess blinking
  • Sensitivity to light
  • Crusting on the eyelashes that may make them stick together, especially in the morning
  • Blurry vision
  • Eyelashes that fall out or grow in the wrong direction

Diagnosis

The doctor will ask about your symptoms and health history. An eye exam will be done. This is enough to make the diagnosis.

If the diagnosis is not clear, these tests may be done:

  • Culture—to look for signs of bacteria, viruses, or fungus
  • Biopsy —to test a sample of tissue from the eyelid

Treatment

Treatment will depend on the cause. The goal is to ease symptoms. This can be done with supportive care, such as:

  • Gentle cleaning and applying warm compresses to the eyelids to remove crusting
  • Massaging the eyelids
  • Not wearing contact lenses

People who are not helped by these methods may need medicine, such as:

  • Antibiotics to treat infection
  • Corticosteroids to ease inflammation

Prevention

There are no known methods to lower the risk of this health problem.

RESOURCES:

Eye Smart—American Ophthalmology
http://www.geteyesmart.org

National Eye Institute
http://www.nei.nih.gov

CANADIAN RESOURCES:

Canadian National Institute for the Blind
http://www.cnib.ca

Canadian Ophthalmological Society
http://www.cos-sco.ca

REFERENCES:

Blepharitis. American Optometric Association website. Available at: https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/blepharitis?sso=y. Accessed March 16, 2021.

Blepharitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/blepharitis. Accessed March 16, 2021.

College of Optometrists. Clinical Management Guidelines: Blepharitis (Lid Margin Disease). College of Optometrists 2016 Feb 5.

Facts about blepharitis. National Eye Institute website. Available at: https://nei.nih.gov/health/blepharitis/blepharitis. Accessed March 16, 2021.

What is blepharitis. American Academy of Ophthalmology website. Available at: https://www.aao.org/eye-health/diseases/what-is-blepharitis. Accessed March 16, 2021.

Last reviewed December 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD  Last Updated: 03/16/2021