Eye Info Portal


Blepharitis is inflammation of the eyelids. It usually involves the eyelid margins where the eyelashes grow and affects both eyelids. It's a common cause of sore, red eyelids and crusty eyelashes. 
The openings (orifices) of oil glands located near the eyelashes become occluded. The pursuing changes lead to irritated and red eyes. Blepharitis is usually associated with an overgrowth of bacteria along the eyelid margins forming a structure called “biofilm”. And, parasitic eyelash mites called “Demodex” feed on this film. Consequently, the overgrowth of these mites on “biofilm” causes a worsening of the eyelid inflammation. 
Bacteria in the eyelid biofilm also produce toxic substances that cause inflammation of oil-secreting glands (meibomian glands) in the eyelids.  This condition is called “meibomian gland dysfunction” which may worsen the symptoms further.
Several diseases and conditions can cause blepharitis.Blepharitis is also frequently associated with some skin conditions, such as seborrheic dermatitis,ocular rosacea, eczema, dandruff etc.  Seborrheic dermatitis is a frequent skin condition that causes skin to become oily or flaky and sometimes involves the eyelids, causing the meibomian glands to block.
Blepharitis and dry eyes may often occur together, causing confusion whether dry eye causes blepharitis or blepharitis causes dry eye. Abnormal tear film, due to unhealthy oil component, interferes with the healthy lubrication of the ocular surface. And the resulting irritation causes symptoms of dry eyes or excess tearing.
 A sty (an acute and painful infection of oil glands near the base of the eyelashes) or a chalazion (a chronic and painless inflammation caused by blockage of oil glands) may frequently be seen in patients with chronic blepharitis. A sty is treated medically, on the other hand, a chalazion usually requires surgery (curettage).
The most common symptoms of blepharitis are sore, red eyelids, burning, itching or stinging eyes, crusty eyelashes, grittiness or foreign body sensations. The both eyes look usually pink due torecurrent attacs of conjunctivitis.
In some cases of blepharitis, the eyelashes can grow abnormally (trichiasis - misdirected eyelashes) or be permanently lost (madarosis). Scarring may occur on eyelids in response to long-term blepharitis. Or the eyelid edges may turn inward or outward (entropion, ectropion).
Blepharitis is usually a long-term condition. Depending on the severity of blepharitis, some or all of these symptoms and findings may be intermittent or constant. 
Blepharitis Treatment
As mentioned before, blepharitis is a long-term (chronic) condition and can not usually be cured completely. However, the symptoms of disease can be controlled with good eyelid hygiene and medication.
Gently scrubbing of eyelid margins in order to remove the biofilm and reduce microbial agents (bacteria and Demodex mites) is the mainstay of treatment. For this purpose, warm compresses with prescribed special cleaning agents or, simply, with diluted baby shampoo can be used. The cotton wool buds can also be used for the application instead of compresses. The really warm application enough to melt (to make more runny) the hardened oily secretion will also clean out the clogged orifices of meibomian glands. A special microwaveable compress can also be used instead of a flannel soaked in hot water.
Mechanical squeezing, thermal or light pulsations can be applied, by health professionals, to melt and express material obstructing the meibomian glandsas “in-office procedures”. The patients themselves can apply massaging over the closed eyelids to squeeze out the oily secretion either by finger or cotton wool buds on the daily hygiene basis.
Topical antibiotics or steroids may also be prescribed to reduce the bacteria and resulting inflammation. Tea tree oil (TTO) containing products (shampoo or cream etc) have been shown effective in treating blepharitis associated with Demodex.