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Blepharitis

Blepharitis is a common eye condition. Learn about blepharitis causes, symptoms, types, treatments and more.

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What is blepharitis?

Blepharitis is when the eyelids on both eyes are inflamed. They go red, swollen, and you may get crust forming. Anyone can get it, though it's more common in older people. It's a long‑lasting condition that comes and goes. It's rarely serious as long as it is kept on top of.

Blepharitis symptoms

Blepharitis might 'look' different, depending on the underlying cause. But here are the main blepharitis symptoms that people often experience.

  • Inflamed eyelids – Flares can make your eyelids sore, swollen, puffy and warm due to increased blood flow. 

  • Itchy eyelids ‑ Your eyelids may feel itchy because of the inflammation or scaling on the skin around your eyes. 

  • Eyelid crusting ‑ You might notice a crust forming along the edges of your eyelids and the base of your eyelashes. It's normally worse in the morning. It might bleed a little if you try to pull the crust away.

  • Eyelid sticking ‑ If you get crusty eyelids, they may stick together. Again, this is often more of a noticeable issue in the morning.

  • Gritty feeling – It might feel like there’s sand in your eye, often caused by dry eyes as a result of the blepharitis. 

  • Red, bloodshot eye ‑ Veins in the sclera (the whites of your eyes) may become more noticeable when your blepharitis flares up, causing red eye or pink eye. 

  • Blinking more often ‑ You may find yourself blinking more than usual. Blepharitis can cause problems with the quality of your tears, so you need to blink more to keep your eyes lubricated.

  • Watery eyes ‑ If blepharitis is reducing the quality of your tears, they might 'run' off the surface of your eyes. You might notice excessive watering or tears running down your face. 

  • Light sensitivity ‑ You might notice your eyes are more sensitive to light when you have a flare‑up of blepharitis. This may be because of problems with tear quality 

An optician delivers an eye test to a customer

Do these symptoms sound familiar?

If you have experienced any of the symptoms mentioned above it's worth booking an appointment with one of our optometrists.

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Complications of blepharitis

If you get your blepharitis seen by an optometrist, they will help you manage the condition.

This should reduce how often you get flare‑ups and make them less uncomfortable when they do happen.

If not properly treated, blepharitis can lead to other eye conditions.

  • Eyelid scarring ‑ Because of repeated damage caused by flare‑ups, the edges of your eyelids may develop scarring.

  • Eyelash problems ‑ Over the long term, repeated flare‑ups can make your eyelashes fall out, grow in the wrong direction, or they might lose colour.

  • Stye ‑ A stye is a painful lump that grows at the base of your eyelashes and is usually caused by an infection. Blepharitis can lead to the development of styes. 

  • Chalazion ‑ A chalazion is a lump that grows on the inside of your eyelid. It's caused by a blocked oil gland and is usually painless. 

Types of blepharitis

There are a few different types of blepharitis. Each has different causes, but they often lead to similar symptoms, such as itchy, sore or crusty eyes.

  • Anterior blepharitis: This affects the outer edges of your eyelids. It’s often linked to skin conditions like dandruff or rosacea, and can also be caused by bacteria or allergies. You might notice flakes or crusts at the base of your lashes.

  • Posterior blepharitis: This affects the inner edges of your eyelids, where your meibomian glands sit. These glands normally release oil into your tears, but if they’re blocked or not working properly, it can lead to irritation and blurry vision.

  • Demodex blepharitis: This type is caused by tiny mites called Demodex that live in your eyelashes and hair follicles. In small numbers, they’re harmless. But if there are too many, they can irritate your eyes and cause inflammation.

  • Mixed blepharitis: This is when you have more than one type at the same time – most commonly a mix of anterior and posterior blepharitis.

Causes of blepharitis

Blepharitis causes aren't fully understood, likely involving multiple factors:

  1. Presence of bacteria

    Anterior blepharitis often involves Staphylococcus bacteria, which normally lives on skin but can flare up in some people.

  2. Dandruff

    Seborrheic dermatitis can cause flaking and irritation on the eyelids, often linked to anterior blepharitis.

  3. Rosacea

    This is a skin condition that causes flare‑ups on your face. It can affect the eyelids and may contribute to anterior blepharitis.

  4. Mites or lice

    Microscopic organisms can grow on your eyelashes, the follicles that your eyelashes come out of and in your eye's oil glands.

  5. Dry eye syndrome

    If you don’t produce enough tears, it can lead to irritation and raise the risk of blepharitis. Learn more about dry eye syndrome.

  6. Meibomian gland issues

    These oil glands can get blocked, causing dryness and are the main cause of posterior blepharitis.

  7. Allergies and irritants

    Pollen, pet hair, dust or chemicals can trigger blepharitis in some people. Learn more about hay fever.

  8. Make‑up

    If you use make‑up heavily or don't clean it off fully, then this could potentially block your glands or irritate your eyelids.

  9. Having oily skin

    People with naturally oily skin might be more likely to develop blepharitis than others.

  10. Hormonal changes

    At certain life stages, your hormone levels change a lot. This might increase your chances of things like oily skin. This can make it more likely you'll develop blepharitis.

  11. Certain medications

    Some medications might affect your body's hormones or your natural defences against bacteria on your skin. This could make it more likely you'll develop blepharitis.

How is blepharitis diagnosed?

If you think you have symptoms of blepharitis, book an appointment with your optometrist.

Our optometrists are very experienced at diagnosing eye conditions like blepharitis and have equipment that helps work out what's going on.

  • Medical history: The optometrist will want to know more about when the symptoms started, if you notice any patterns (such as the time of day it flares up), and which symptoms you get. 

  • Slit lamp test: A slit lamp is a powerful microscope with a light attached. It allows the optometrist to view your eyelid up very close. This will let them see any scaling, mites, eyelash problems and other issues.

  • Tear break‑up test: Blepharitis can affect the quality of your tears. A tear break‑up test measures how long it takes for your tears to split after you blink. Anything less than 10 seconds is often a sign of a problem with tear quality.

  • Eyelid swab: In rare cases, usually in a hospital setting, a doctor might take a swab from your eyelid if they suspect an infection is causing your blepharitis. 

How is blepharitis treated?

Blepharitis can often be treated with some simple home remedies.

However, if it's not clearing up or keeps coming back, it's really worth booking an appointment with your optometrist.

Here are the main kinds of blepharitis treatment.

  • Treating underlying causes (if known) ‑ If your blepharitis is caused by another condition (such as rosacea or dry eye syndrome), then your optometrist or GP will aim to treat this first.

  • Eyelid wipes ‑ There are various kinds of wipes available, which you can use to gently wipe your eyelids and clear discharge and skin flakes. They might also help prevent eyelid bacteria buildup.

  • Warm compress ‑ If your blepharitis is caused by blocked meibomian glands or you get sticky discharge or flakes on your eyelids, holding a warm, microwaveable compress to your eyelids can help loosen them up so you can gently cleanse them.

  • Eyelid massage – Gently press and move your eyelids in circles for 30 seconds to help clear blocked glands.

  • Lubricating eyedrops ‑ If your blepharitis means you have dry eyes, then artificial tears can really help. You apply drops a few times per day, and this can prevent the sore, dry, scratchy feeling.

  • Antibiotics ‑ If your blepharitis is caused by a buildup of bacteria, your GP or optometrist might prescribe you some mild antibiotic eye drops or tablets that will fight off the outbreak.

  • Dietary changes ‑ There is some evidence that omega‑3 oils, which can be found in oily fish, walnuts, flaxseeds and chia seeds (as well as supplements), can help improve symptoms.

  • Cool compress ‑ If you find the inflammation very uncomfortable, a cool compress can really relieve the discomfort. Put a damp cloth in the fridge to cool down, then hold it over your eyelids.

  • In‑practice eyelid treatments ‑ If your symptoms are more persistent, your optometrist might recommend a specialist treatment in‑store. 

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How to prevent blepharitis

Blepharitis is often a long‑term, chronic condition and will flare up from time to time.

Unfortunately, there isn't a permanent cure for many people. But there are some things you can do to reduce the chances of it coming back.

  • Eyelid cleansing routine ‑ Because some people are more prone to blepharitis flare‑ups, following a daily eyelid cleansing routine can reduce the chances of it happening

  • Don't rub ‑ While it's tempting to rub a sore, itchy eye, this won't relieve the symptoms for long, and could make them worse. 

  • Make‑up habits ‑ If you wear make‑up, it might be worth thinking about changing your habits. Ideally, it's best to avoid make‑up altogether 

  • Rest – Tiredness and stress can trigger flare‑ups. Aim for good sleep (7‑9 hours) and try to manage stress as best you can.

  • Regular eye appointments ‑ If you have blepharitis, it's valuable to see your optometrist on a regular basis. 

Blepharitis FAQs

Written by our experts for peace of mind

https://images.ctfassets.net/zcryw81f0g1x/5mrcuMDlru21b9LMMuIQn7/34dcf1c5e9fe3ed41c4ea4077537d61f/Ross_Campbell_Northallerton.jpg

Ross Campbell

BSc Hons MCOptom Prof Cert Glauc Prof Cert Med Ret

Ross is an experienced optometrist having graduated in 2007 from Bradford University. He is also ophthalmic director of Specsavers Swaledale with Northallerton & Thirsk, a pre‑registration supervisor, professional advancement consultant, and a WOPEC Lead Assessor. He has previously worked as Director of Optometry Advancement for Specsavers and as a columnist for Optician & ProFile magazine.

Related conditions

Not sure if this is what you're experiencing? Explore some related conditions:

  • Dry Eye Syndrome

    Dry eye syndrome is a condition that happens when your eyes don’t produce enough tears or if the quality of your tears isn’t quite right.

    Find out more

  • Hay Fever

    A common cause of allergic rhinitis, hay fever is an adverse reaction to pollen that many people experience, particularly in the summer.

    Find out more

  • Autoimmune inner ear disease (AIED)

    An autoimmune reaction happens when the immune system mistakes the healthy cells and tissues in the body for viruses or bacteria that it needs to fight off.

    Find out more

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If you’ve noticed a change in your vision, or have experienced any symptoms mentioned above, it’s worth booking an appointment with one of our optometrists.

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