Blepharitis is a common eyelid inflammation causing redness, irritation, crusting, and soreness around the eyelashes. It can result from bacterial infections, skin conditions, or meibomian gland dysfunction, often leading to chronic discomfort.
Blepharitis is a broad term used to describe inflammation of the eyelids. Common symptoms include sore, irritated eyelids and the formation of crusts around the eyelashes and eyelids.
This condition is highly prevalent. A study conducted in the United States found that 37% of ophthalmology patients and 47% of optometry patients had experienced blepharitis symptoms at some point. (Lemp MA et al., 2009)
Interestingly, the study also revealed that younger individuals were more likely to report blepharitis symptoms than older adults—contradicting the common assumption that eyelid inflammation primarily affects older populations.
Serious damage can occur to your eyes or eyelids if blepharitis is left untreated. It is recommended that you visit your local doctor or eye specialist if the symptoms last more than a week.
There are several possible causes of blepharitis, including:
Symptoms for dry eyes often occur simultaneously with blepharitis. It is unclear whether it is dry eyes that are the cause of the blepharitis infection, or if blepharitis causes dry eyes.
Recent studies have led medical professionals to believe that these two symptoms may form a newly identified chronic eye condition known as Dry Eye Blepharitis Syndrome (DEBS).
Blepharitis is commonly associated with an overgrowth of bacteria along the edges of the eyelids, particularly around the eyelash follicles. Over time, these bacteria multiply and form a biofilm, a toxic layer similar to dental plaque.
This biofilm creates an ideal environment for Demodex eyelash mites, allowing them to thrive and multiply, further exacerbating eyelid inflammation. Additionally, bacteria within the biofilm release exotoxins, which can inflame the meibomian glands—oil-producing glands essential for maintaining a stable tear film. This inflammation contributes to Meibomian Gland Dysfunction (MGD), often worsening dry eye symptoms.
Other contributing factors include poor eyelid hygiene. The accumulation of oil, dirt, or debris at the base of the eyelashes can lead to infection. A major culprit is inadequate removal of makeup, which can trap bacteria and further aggravate eyelid inflammation.
Common blepharitis symptoms are listed below:
Patients may experience some or all of the above symptoms, and may not always be present. In rare cases, loss of eyelashes – known as madarosis may occur.
Blepharitis is also common among contact lens wearers, as improper use or poor eye hygiene can create an ideal environment for bacterial growth and parasitic infestations. Failure to properly clean and disinfect contact lenses, extended lens wear, or sleeping with lenses can increase bacterial buildup, leading to eyelid inflammation and worsening symptoms. Regular lens hygiene and proper eye care are essential in reducing the risk of blepharitis in contact lens users.
Visit with your eye specialist or doctor to ascertain the cause of your blepharitis or eyelid infection/inflammation. A thorough investigation of the eyes and eyelids will allow the doctor to evaluate whether you are indeed suffering from blepharitis and prescribe the appropriate blepharitis treatment.
Depending on the medical profession you visit, blepharitis treatments may include:
Gentle scrubbing of eyelids will remove biofilm and excess bacteria from your eyelids and base of the eyelashes. Your eye doctor will suggest a regular regimen of warm compresses and lid scrubs to keep your eyelids clean. The amount of bacteria and Demodex mites present on your eyelids will also be significantly reduced as a result.
At home, special eyelid foam wash or diluted baby shampoo can be used as a cleaning agent for an eyelid scrub. At the clinic, our eye specialist can clean your eyes with an in-office Blephex treatment, which cleanses and eradicates demodex mites effectively.
Your doctor may prescribe eye drops or topical ointments to help control excess bacteria and other microorganisms present on the eyelids. These medications are typically applied using a clean cotton swab to ensure proper hygiene.
Treatment becomes especially important if there is a risk of infection spreading to the eye. If your doctor suspects that blepharitis has led to or coincides with conditions like conjunctivitis or another eye infection, appropriate medication will be prescribed to prevent further complications and promote healing.
Eyelid hygiene is crucial in the treatment and management of blepharitis symptoms. Improper hygiene may lead to a worsening of the blepharitis condition.
First, use clean, warm compresses to help unblock residue in the meibomian glands in your eyelids. Here’s how:
Your doctor will have recommendations on how often and regularly you will need to use the warm compress during your treatment and recovery. As a general guideline, you will need to keep your eyes covered for longer periods of time and employ the warm compresses more often during the start of treatment. As your condition improves, the time and regularity of using the warm compress can gradually be reduced.
At Asia Retina, we are able to isolate the demodex mite by placing a single eyelash under the microscope. Demodex is easily treated by anti-parasite ointment and eyedrops; although there is chance of recurrence. If you experience prolonged eye itchiness or discharge, get your eyes checked for any insidious infections.
