Overview

Blepharitis (blef-uh-RYE-tis) is inflammation of the eyelids. Blepharitis usually involves the part of the eyelid where the eyelashes grow and affects both eyelids.

Blepharitis commonly occurs when tiny oil glands located near the base of the eyelashes become clogged. This leads to irritated and red eyes. Several diseases and conditions can cause blepharitis.

Blepharitis is often a chronic condition that is difficult to treat. Blepharitis can be uncomfortable and may be unsightly. But it usually doesn't cause permanent damage to your eyesight, and it's not contagious.

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Symptoms

Blepharitis symptoms and signs include:

• Watery eyes
• Red eyes
• A gritty, burning or stinging sensation in the eyes
• Eyelids that appear greasy
• Itchy eyelids
• Red, swollen eyelids
• Flaking of the skin around the eyes
• Crusted eyelashes upon awakening
• Eyelid sticking
• More frequent blinking
• Sensitivity to light
• Eyelashes that grow abnormally (misdirected eyelashes)
• Loss of eyelashes

When to see a doctor

If you have blepharitis symptoms and signs that don't seem to be improving despite good hygiene — regular cleaning and care of the affected area — make an appointment with your doctor.

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Causes

The exact cause of blepharitis isn't clear. It may be associated with one or more factors, including:

• Seborrheic dermatitis — dandruff of the scalp and eyebrows
• A bacterial infection
• Clogged or malfunctioning oil glands in your eyelids
• Rosacea — a skin condition characterized by facial redness
• Allergies, including allergic reactions to eye medications, contact lens solutions or eye makeup
• Eyelash mites or lice

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Diagnosis

Tests and procedures used to diagnose blepharitis include:

• Examining your eyelids. Your doctor will carefully examine your eyelids and your eyes. He or she may use a special magnifying instrument during the examination.
• Swabbing skin for testing. In certain cases, your doctor may use a swab to collect a sample of the oil or crust that forms on your eyelid. This sample can be analyzed for bacteria, fungi or evidence of an allergy.

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Complications

If you have blepharitis, you may also experience:

• Eyelash problems. Blepharitis can cause your eyelashes to fall out or grow abnormally (misdirected eyelashes).
• Eyelid skin problems. Scarring may occur on your eyelids in response to long-term blepharitis. Or the eyelid edges may turn inward or outward.
• Excess tearing or dry eyes. Abnormal oily secretions and other debris shed from the eyelids, such as flaking associated with dandruff, can accumulate in your tear film — the water, oil and mucus solution that forms tears. Abnormal tear film interferes with the healthy lubrication of your eyelids. This can irritate your eyes and cause symptoms of dry eyes or excess tearing.
• Difficulty wearing contact lenses. Because blepharitis can affect the amount of lubrication in your eyes, wearing contact lenses may be uncomfortable.
• Sty. A sty is an infection that develops near the base of the eyelashes. The result is a painful lump on the edge (usually on the outside part) of your eyelid. A sty is usually most visible on the surface of the eyelid.
• Chalazion. A chalazion occurs when there's a blockage in one of the small oil glands at the margin of the eyelid, just behind the eyelashes. The gland can become infected with bacteria, which causes a red, swollen eyelid. Unlike a sty, a chalazion tends to be most prominent on the inside of the eyelid.
• Chronic pink eye. Blepharitis can lead to recurrent bouts of pink eye (conjunctivitis).
• Injury to the cornea. Constant irritation from inflamed eyelids or misdirected eyelashes may cause a sore (ulcer) to develop on your cornea. Insufficient tearing could predispose you to a corneal infection.

Alternative medicine

No alternative medicine treatments have been found to conclusively ease the symptoms of blepharitis. However, a diet rich in omega-3 fatty acids or supplements containing omega-3 fatty acids may be helpful for blepharitis associated with rosacea. Omega-3 fatty acids are found in foods such as salmon, tuna, trout, flaxseed and walnuts.

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Lifestyle and home remedies

Self-care measures such as the following may be the only treatment necessary for most cases of blepharitis.

Clean your eyes daily

If you have blepharitis, follow this self-care remedy two to four times a day during flare-ups and once or twice a day after the condition is under control:

• Apply a warm compress over your closed eye for several minutes to loosen the crusty deposits on your eyelids.
• Immediately afterward, use a washcloth moistened with warm water and a few drops of diluted baby shampoo to wash away any oily debris or scales at the base of your eyelashes. Use a different clean cloth for each eye.
• In some cases, you may need to be more deliberate about cleaning the edge of your eyelids where your eyelashes are located. To do this, gently pull your eyelid away from your eye and use the washcloth to gently rub the base of the lashes. This helps avoid damaging your cornea with the washcloth. Ask your doctor whether you should use a topical antibiotic ointment after cleaning your eyelids in this way.
• Rinse your eyelids with warm water and gently pat it dry with a clean, dry towel.

It also may be a good idea to stop using eye makeup when your eyelids are inflamed. Makeup can make it harder to keep your eyelids clean and free of debris. Also, it's possible that makeup could reintroduce bacteria to the area or cause an allergic reaction.

Lubricate your eyes

Try over-the-counter artificial tears. These lubricating eyedrops may help relieve dry eyes.

Control dandruff and mites

If you have dandruff that's contributing to your blepharitis, ask your doctor to recommend a dandruff shampoo. Using a dandruff-controlling shampoo may relieve your blepharitis signs and symptoms. Using tea tree shampoo on your eyelids each day may help deal with mites. Or try gently scrubbing your lids once a week with a 50 percent tea tree oil, which is available over-the-counter.

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