Blepharitis refers to inflammation of the eyelids, particularly at the lid margins. It’s a common disorder and may be associated with a low-grade bacterial infection or a generalized skin condition.
Blepharitis occurs in two forms: anterior blepharitis and posterior blepharitis. Anterior blepharitis affects the outside front of the eyelid where the eyelashes are attached. The two most common causes are scalp dandruff and bacteria.
Posterior blepharitis affects the inner eyelid and is caused by problems with the oil (meibomian) glands in the eyelid. Two skin disorders are the cause: acne rosacea and scalp dandruff.
Regardless of which type of blepharitis you have, you will probably have such symptoms as eye irritation, burning, tearing, foreign body sensation, crusty debris (in the lashes, in the corner of the eyes or on the lids), dryness and red eyelid margins.
Allergies can trigger other problems, such as conjunctivitis (pink eye) and asthma. Combined nasal and eye allergies create a condition known as rhinoconjunctivitis.
It is important to see your eye doctor for treatment. If your blepharitis is bacterial, possible long-term effects are eyelash loss, ectropion, thickened lid margins, dilated and visible capillaries, trichiasis and entropion. The lower third of the cornea may exhibit significant erosion.
Depending on the type of blepharitis you have, treatment may include applying warm compresses to the eyelids, cleansing them, using an antibiotic and/or massaging the lids.
If blepharitis makes your eyes feel dry, your doctor also may prescribe artificial tears or lubricating ointments or suggest silicone punctal plugs. Sometimes steroids are used to control inflammation, but the potential side effects speak against long-term use.
The warm compress portion of treatment is designed to loosen crusts on your eyes before you cleanse them. Cleansing the eyelids is essential to blepharitis treatment. Your doctor will recommend what cleansing agent to use, such as warm water only, salt water, baby shampoo diluted with warm water or a special over-the-counter product made specifically for cleansing the lids.
Antibiotic treatment is recommended only for certain types of blepharitis. Your doctor may prescribe either a topical antibiotic ointment or an oral antibiotic. Because blepharitis tends to be chronic, expect to keep up therapy for a long period of time.
It’s a good idea never to use eye makeup, which can interfere with eyelid hygiene and massage treatments. With some kinds of blepharitis, you may need to use an anti-dandruff shampoo for your scalp and eyebrows. But take extra care to keep shampoo out of your eyes to avoid irritation.