Blepharitis is inflammation of the eyelids. There are two forms: anterior blepharitis, which happens when the eyelids become infected, and posterior blepharitis, which happens when glands in the eyelids become blocked and inflamed.

Anterior blepharitis can be cured. Posterior blepharitis cannot, but it can be treated to relieve symptoms.

Blepharitis symptoms

Blepharitis is not contagious, but it can be uncomfortable and annoying. Symptoms can include eye redness, irritation, itching and burning or a feeling that you have something in your eye. Your eyelids might look red and irritated, flaky or scaly. Blepharitis can cause dry eye or make it worse.

Both anterior and posterior blepharitis can cause a buildup of crusty yellow or white material on the lashes. (A small amount of crusting is normal when you wake up, but if you notice a lot or notice it when you have not been sleeping, this could be a sign of blepharitis.)

What causes blepharitis?

Anterior blepharitis is commonly caused by bacteria (staphylococcal blepharitis) or dandruff of the scalp and eyebrows (seborrheic blepharitis). Although less common, it may also be the result of allergies or an infestation of Demodex mites within the eyelashes.

Posterior blepharitis is caused by inflammation of the eyelid glands that produce oil and can be associated with skin conditions such as acne rosacea and scalp dandruff. The oil-producing glands are called the Meibomian glands. When they are inflamed, they do not produce oil normally, and blepharitis can result.  This oil is an important part of the thin film of tears that covers your eyes to keep them moist and comfortable. Posterior blepharitis is much more common than anterior blepharitis, but it is important to know the cause before trying any blepharitis treatment. If you think you might have blepharitis, see an eye doctor.

Blepharitis treatments

The main treatment for anterior blepharitis caused by bacteria is antibiotics. Antibiotic treatment can be in the form of pills, drops or ointments.

Blepharitis caused by Demodex mites is treated by cleaning the lids with tea tree oil based solutions. (Do not try this treatment without consulting an eye doctor first, because using tea tree oil incorrectly can damage your eyes.) A treatment called “eyelid hygiene” can also help some cases of anterior blepharitis.

Posterior blepharitis treatments include:

  • Eyelid hygiene—described below
  • Antibiotic ointment on the lids
  • Antibiotics by mouth
  • Nutritional supplements, such as fish oil
  • Dry eye medications, such as Restasis and artificial tears
  • Other medications

Blepharitis home treatment—eyelid hygiene

Home treatment is the first treatment for many cases of posterior blepharitis and helps some people with anterior blepharitis, depending on the cause. Eyelid hygiene consists of warming, massaging and cleansing the eyelids regularly. This unclogs the eyelids’ oil glands, reduces crusting and improves dry eye symptoms.

  • Place a gel mask in the microwave for 8-15 seconds until warm, not hot. (You can use a warm washcloth, but this needs to be reheated every 1-2 minutes.)
  • Press the mask or washcloth against your closed eyelids and eyelashes for 4-8 minutes.
  • Remove the mask or washcloth and start eyelid massage. Place your clean index finger on the outside of your eyelid, near the lashes. Press the eyelid firmly against the eyeball, toward the back of your head. Press for 4 seconds in 4 areas along the eyelid, for all 4 eyelids (upper and lower on each eye). Remember this by using “the rule of fours.” The massage might briefly cause blurry vision.
  • Do lid scrubs. Use eyelid cleansing foam or cleansing pads to gently scrub the lashes and edges of all 4 eyelids (upper and lower on each eye) to remove crusting. Keep your eyes closed and rinse off all the cleanser before opening your eyes. Oregon Eye Specialists offers some cleansing foam and pads for purchase, or you may use a wet washcloth and a drop of baby shampoo.

Many people with blepharitis also have dry eye. Blepharitis makes dry eye symptoms worse and can be one cause of dry eye as the oil-producing glands in the eyelids are blocked, causing tears to evaporate more quickly from your eye’s surface.

If your posterior blepharitis treatment plan is not working, or you don’t remember or want to follow the steps for eyelid hygiene and other treatments, a dry eye treatment called LipiFlow could help.

LipiFlow for dry eye and blocked oil glands

LipiFlow is a newer procedure that offers relief to patients struggling with dry eye symptoms caused by blocked meibomian glands (evaporative dry eye). Because of this, patients with posterior blepharitis may also appreciate improvement in symptoms from LipiFlow. Although this technology is relatively new, it is a very safe and low risk procedure done right in your eye doctor’s office. Oregon Eye Specialists now offers this advanced procedure. Talk to your doctor if you think LipiFlow could be right for you.

Questions about blepharitis?

If you think you have blepharitis or another eye problem, or have tried blepharitis treatments without success, please feel free to contact Oregon Eye Specialists. We have 10 convenient locations and are always accepting new patients of all ages. Call 503-935-5580 or request an appointment online today.

 

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