What Is Blepharitis?

Blepharitis is inflammation of the eyelids that can cause them to become swollen, irritated, and red. It's also characterized by crusty dandruff-like flakes on your eyelashes. This condition can be caused by having too many bacteria on your eyelids at the base of your eyelashes or a blocked or irritated oil gland on your eyelid.

In this article, we'll discuss the different types of blepharitis, symptoms, risk factors, and treatments for this condition.

Types of Blepharitis

The two types of blepharitis are:

• Anterior blepharitis: This type of inflammation mostly affects the outside of your eye. This includes the area along the outer lash line where your eyelashes attach to your eyelid. It usually happens because of bacteria on your skin or dandruff (flaky patches of skin) from your scalp or eyebrows. Allergies or mites (tiny parasites) may also cause anterior blepharitis.
• Posterior blepharitis: This type affects the inner part of the eyelid that borders your eyeball. Posterior blepharitis usually develops when the oil glands on your eyelids become clogged or aren't working properly, creating too much or too little of an oil called meibomian. Common skin conditions like rosacea, which causes redness and bumps, usually on your face, and dandruff can cause posterior blepharitis.
  

Blepharitis Symptoms

The main symptom of blepharitis is a red, itchy, and swollen eyelid. The condition can also cause other symptoms, including:

• Crusty dandruff-like flakes on your eyelashes
• Feeling like there is something in your eyes
• Watery eyes
• Tears that are foamy or have small bubbles in them
• Dry eyes
• Sensitivity to light

Blepharitis can also cause more serious problems like:

• Blurry vision
• Eyelashes that fall out
• Eyelashes that grow in the wrong direction
• Swelling of other parts of the eye, like the cornea, the clear outer layer at the front of the eye
  

Causes

Most of the time, blepharitis develops from too many bacteria on your eyelids at the base of your eyelashes. Having bacteria on your skin is normal, but too many bacteria can cause problems. You can also get blepharitis if the oil glands in your eyelids get clogged or irritated.

Diagnosis

Your healthcare provider will examine your eye using a bright light or magnifier. They will look at your eyes, eyelids, and eyelashes, and may refer you to an eye specialist, either an optometrist or ophthalmologist.

If your provider wants to identify specific types of bacteria, they may use a swab to collect tears or other discharge from your eye. However, this is not routinely done. The swab will be tested in a lab to see what type of bacteria could be causing the irritation.

Treatment

The best way to treat blepharitis is to keep your eyelids clean.

Steps for cleaning your eyes when you have blepharitis include:

• Wash your hands before touching your eyes.
• Use warm water and gentle cleansers only.
• Use a soft cloth or cotton swab to apply the cleaning solution.
• Press the cloth against your eyes and hold it there to loosen buildup and open oil glands.
• Gently rub the cloth along your eyelid, focusing on the area at the base of your eyelashes.
• Rinse your eye with clean water when you are done.
• If you need to repeat these steps on the other eye, use a new cloth or cotton swab.
• Put a heating mask on your eyes.

If good hygiene isn't enough to clear up the inflammation or keep your chronic blepharitis in check, your healthcare provider may suggest the following treatments:

• Eye drops: Your provider may prescribe steroid eye drops to control the redness, swelling, and irritation. They may also recommend a type of eye drop called artificial tears. You can get these eye drops without a prescription. However, steroids have side effects, such as cataracts (clouding of your eye’s lens) and glaucoma (a group of eye conditions causing damage to the eye’s optic nerve).
• Medicines that fight infection: If your blepharitis is caused by bacteria, your provider may prescribe antibiotic eye drops, ointments, or pills.

You may also need to keep other conditions that increase your risk of developing blepharitis, like rosacea and dandruff, under control. Rosacea is typically managed with sun protection, trigger avoidance, and the use of gentle cleansing products, while dandruff is treated with dandruff shampoo and scalp treatments.

Prognosis

Blepharitis usually doesn’t go away completely. You’ll need to follow a routine for cleaning your eyelids regularly to keep it under control.

If blockages and irritation or infection become severe, it can lead to other eye conditions or even secondary infections, including:

• Stye: A red, painful bump on the eyelid caused by a blocked oil gland
• Chalazion: A hard, painless lump on the eyelid caused by a blocked oil gland that often happens when you have a stye that doesn’t go away
• Dry eye: A result of oil and flakes building up in your tear film (a thin layer of tears across the surface of your eye)
• Damage to the cornea: A result of inflammation caused by bacteria on the lid
• Chronic red eye: A result of blepharitis making the white part of your eye look red all the time

Coping

Clean your eyes regularly and use warm compresses to help keep the oil glands in your eyelids open and clear. Keeping other conditions like dandruff and oily skin under control can also help reduce flare-ups.

You also want to be sure to prevent bacteria from entering your eyes. One way to do this is to regularly replace eye drops, contacts, and eye cosmetics. Using products that are old or possibly contaminated can increase your risk of developing all kinds of infections in your eye.

Summary

There are a lot of things that can cause irritation to your eyes. Bacterial overgrowth, skin cell buildup, or blockage in the oil glands in your eyelids can all lead to blepharitis. Blepharitis is a common eye problem, especially among those who have conditions like rosacea or dandruff.

Maintaining good eye hygiene is the best way to clear up and prevent blepharitis. Keeping your blepharitis under control is key to preventing more serious complications.

A Word From Verywell

For many people, blepharitis is a chronic condition that can be uncomfortable but rarely causes serious problems. Knowing what is causing your blepharitis can help you keep it under control. Your healthcare provider can examine your eye to try to determine a cause. No matter what is causing the inflammation in your eye, warm compresses and careful cleaning are the first steps in treating blepharitis.