Overview
Blepharitis is inflammation where the eyelashes meet the lid. It comes in two overlapping flavours: anterior, affecting the lash line and often bacterial or seborrhoeic, and posterior, where the oil glands inside the lid become blocked and inflamed.
It is chronic and it recurs. Treatment is about control rather than cure, and it is the single most common thing sitting underneath stubborn dry eye and recurrent styes.
What are the common symptoms?
- Crusting or flaking along the lash line, worst in the morning
- Red, swollen, sore lid margins
- Gritty, burning eyes
- Lashes that stick together, or fall out
- Recurrent styes or chalazia
- Contact lens intolerance
What causes it, and who is at risk?
- Blocked and inflamed meibomian glands
- Bacterial overgrowth at the lash line
- Seborrhoeic dermatitis and dandruff
- Rosacea — a strong association
- Demodex mites in the lash follicles
- Eye make-up and incomplete removal of it
How is it treated?
Lid hygiene done properly and consistently outperforms almost everything else. The mistake most people make is stopping as soon as it improves.
- Warm compresses for several minutes to soften the gland oils
- Lid margin cleaning with a dedicated wipe or diluted cleanser, daily
- Topical or, for rosacea-associated cases, oral antibiotics
- Tea tree based products where Demodex is involved
- In-practice gland expression or thermal treatment
- Lubricating drops for the accompanying dryness
This page is general information, not a diagnosis. Only an eye care professional who has examined you can tell you what is actually going on.