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Everything you need to know about Blepharitis

In the simplest of terms, an inflammation of the eyelids is known as blepharitis. While this inflammatory condition itself is a very common and mild, it can progress to having serious consequences which is why it needs to be treated immediately.


Infections and Mites

The eyelids are an important structure of the ophthalmic system. They are flaps of skin where the edge is lined by lashes. It also has oil secreting meibomian glands. A small population of bacteria and parasitic Demodex mites also exist near the lash margin. This edge can often become infected when there is an increase in the existing bacterial population. This leads to the formation of biofilm, a structure that acts as a rich environment for an increase in the number of Demodex mites.
Infections of the conjunctiva (pink eye) are also associated with this condition.

Meibomian Gland Dysfunction

This is associated with the increase in the number of bacteria which secrete exotoxins that leads to the inflammation of the meibomian glands. The meibomian glands secrete oil onto the surface of the eye and helps stabilize the tear film. Meibomian Gland Dysfunction, or meibomianitis, can be associated with insufficient secretion of the oils that make up the tear film. This can lead to dry eyes.

Dry Eye Blepharitis Syndrome

An inflammation of the eyelid can progress to the development of dry eyes. This makes sense as eyelids play a major role in maintaining the moist environment of the eye by helping spread tear film across the surface of the eyeball. Since both these ailments were often found together, doctors combined them under a common condition called Dry Eyes Blepharitis Syndrome (DEBS)

Skin Conditions

Many allergic and autoimmune skin conditions can also contribute to inflammation of the eyelids. These include eczema, psoriasis, rosacea and dandruff.

Signs and Symptoms

There is a wide array of other symptoms associated with this eye condition. Depending on the cause, one or more of the following maybe present:

  • Irritation of the eye. This can be felt as the a burning or stinging sensation
  • The margin of the eyelid can have accumulation of a dry, flaky substance
  • There can be excessive watering of the eyes
  • Discomfort because of itchiness of the eyelids.
  • The feeling of a foreign body being present
  • Madarosis, the loss of eyelashes
  • Difficulty in the usage of contact lenses

The Treatment

Like for all medical ailments, it is important that you consult a doctor for a treatment plan. The doctor will view your symptoms and perform examinations that will help diagnose the cause of your inflammation. A treatment plan based on your cause will then be communicated to you.

Eyelid hygiene

The most important part of treating this is cleaning any debris and disinfecting your eyelid from any microbial buildup. This can be done at home or by a professional.
The at home regimen for treating this condition includes gently scrubbing your eyes, especially near the lid margins so that you may eradicate any bacterial buildup causing the inflammation. The cleaning of the eyelid maybe further augmented by the use of prescription cleaners and baby shampoo diluted with warm water. The steps are detailed as below:

  1. Sanitize your hands by washing them for at least 20 seconds with soap and water
  2. Use your choice of cleaning solution to dampen a cotton swab
  3. Run the cotton swab near both upper and lower lid margins. Make sure you do so gently. Take care during this step to prevent the solution from getting into your eye
  4. Thoroughly rinse out your eye with warm water to wash away the cleaning solution and any debris
  5. Repeat steps 3 and 4, for the other eye. Remember to use a clean cotton swab!

Meibomianitis can also cause this inflammatory condition; this is why warm compresses are necessary to melt any build up in the glands and clear up any blockage. Warm compresses can be done once a day to several times a day depending on the severity of your condition and as recommended by the doctor.
A step by step guide to warm compression is given below:

  1. Sanitize your hands by washing them for at least 20 seconds with soap and water
  2. Take a clean soft cloth and dampen it with warm water. Make sure the washcloth is at a safe temperature so that it may not cause any burns to your eyelids
  3. Close your eyes and gently place the washcloth on your eyelids. Hold for a few minutes, this will allow the heat from the washcloth to soften any crusts or residue
  4. With gentle motions start moving the washcloth around your eyelid especially targeting the lash line.

The in-office cleaning treatments can also be performed as they are more effective in treating this condition. These include procedures like:

  • Electrochemical Lid Margin Debridement: This targets meibomian gland blockage, bacterial build up and the increase in mites
  • Thermal Pulsation Treatment: This is used to melt residue in meibomian glands as a result of inflammation and blockage
  • Intense Pulsed Light (IPL) Therapy: This cleans out blockage in the meibomian glands


Your doctor may also add ointments and gels to be applied to the eyelid as part of your treatment plan. Most of these tend to be antibacterial in nature. They can also be anti-inflammatory.

Routine Changes

For the time duration of your blepharitis, it would be to stop the using make up products especially those that need to be applied near the lid margin like mascaras and eye liners. Contact lenses should also not be worn during this period. This is because they can lead to bacteria from the eye lid transferring to your contact lenses, which can progress to conjunctivitis.

Tips for Preventing Reoccurrence

  • Incorporate omega 3 fatty acids into your diet to keep your meibomian glands healthy.
  • Use daily disposable or glass permeable contact lenses
  • Remove make up before sleeping to prevent infections
  • Use non-prescription cleansers to prevent bacterial and mite buildup.