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.
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Anterior blepharitis is often caused by a skin condition called seborrheic dermatitis. Posterior blepharitis is often 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.
This problem is more common in middle-aged adults. But, it can affect children too. 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 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—they may stick together, especially in the morning
- Blurry vision
- Eyelashes that fall out or grow in the wrong direction
The doctor will ask about symptoms and past health. 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 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
There are no known methods to lower the risk of this health problem.
- Amescua G, Akpek EK, et al. American Academy of Ophthalmology Preferred Practice Pattern Cornea and External Disease Panel. Blepharitis Preferred Practice Pattern®. Ophthalmology. 2019;126(1):P56-P93.
- 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.
- Blepharitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/blepharitis.
- Facts about blepharitis. National Eye Institute website. Available at: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/blepharitis.
- What is blepharitis. American Academy of Ophthalmology website. Available at: https://www.aao.org/eye-health/diseases/what-is-blepharitis.
- Daniel A. Ostrovsky, MD
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