Blepharitis - Definitive Guide

Blepharitis is a condition that causes inflammation of the eyelids. 

It is a common condition that is more likely to affect people with oily skin or conditions like seborrheic dermatitis (dandruff), acne rosacea, dry eye, and allergies that affect the eye. 

There are 2 different types of blepharitis: 

• Anterior blepharitis —occurs at the front (outside) of the eyelid where the eyelashes grow. It is caused by an inflammatory reaction to bacteria on the skin, or rarely by tiny parasites (mites) that live in the eyelashes. 
• Posterior blepharitis —occurs when oil-producing glands on the inner edge of your eyelid (Meibomian glands) block. 

Blepharitis isn’t usually dangerous, but it can be uncomfortable and is often hard to treat. It is not contagious so cannot be passed on to other people. 

Symptoms of blepharitis include: 

• a red, sore, itchy, swollen eyelid
• watery eyes
• frequent blinking due to eye irritation

Symptoms of blepharitis are often worse in the morning.

Blepharitis is a complex condition, and the exact cause is not fully understood. It may be caused by a variety of factors including: 

• an inflammatory reaction to bacteria — we all have bacteria on our skin that are normally harmless. In some people when bacteria get onto the eyelid it seems to trigger an inflammatory reaction and symptoms of blepharitis.
• skin conditions —  blepharitis is more common in people with oily skin, seborrheic dermatitis, or acne rosacea
• eyelash mites —a tiny parasite called demodex that lives in the eyelashes can trigger blepharitis, though this is uncommon
• blocked oil-producing glands —Meibomian glands on the inner rim of the eyelids produce an oily substance that stops tears from drying out. In Meibomian gland dysfunction (MGD), these glands either produce too much or not enough oil causing problems like dry eye, crusting of the eyelashes, and symptoms of blepharitis.

Unfortunately, there’s no cure for blepharitis, but ongoing treatment can help to manage and reduce symptoms. The most effective way of managing symptoms of blepharitis is to keep your skin, scalp, hair, eyelids, and eyelashes clean. Blepharitis can usually be treated at home. 

At-home treatments for blepharitis

• Keep your skin and hair clean —wash your hair, scalp, and eyebrows with an antibacterial shampoo (your pharmacist can recommend one) 
• Clean your eyelids up to 4 times a day using boiled, then cooled, water and a clean cotton pad. You can also buy special eyelid scrubs from some opticians to clean your eyelids. 
• Wash your eyelashes once or twice a day (using boiled, then cooled, water). To do this:

1. 1. wash your hands with soap and water
   2. add a small amount of baby shampoo to warm water
   3. soak a clean washcloth in the solution and apply to your eyelids for 5 to 10 minutes 
   4. gently massage your eyelids for about 30 seconds —this helps release oily fluid from the blocked Meibomian gland
   5. use a cotton pad or cotton bud to gently clean your eyelashes. 
   6. rinse your eye with clean water
   7. repeat the process on your other eye using a clean washcloth and a new cotton pad or cotton bud. 

• If your eyes are dry, artificial tears can help lubricate them and make your eyes more comfortable. You can buy artificial tears over the counter from pharmacies
• avoid wearing eye makeup or contact lenses if you have symptoms of blepharitis. It’s also a good idea to throw away any eye makeup you had when your symptoms first started and discard any eye makeup that is older than six months. 
• avoid touching, or rubbing your eyes
• some studies have shown that omega-3 oils may be beneficial in reducing symptoms of blepharitis. Omega-3 oils are found naturally in oily fish like salmon and mackerel. You can also buy omega-3 supplements from pharmacies and health food shops.

You should make an appointment with a doctor if your blepharitis has not improved after a few days of home treatment.

If your blepharitis symptoms are no better after using home treatments, your GP may prescribe medication. These may include: 

• antibiotic eyedrops, creams, or ointments
• medications that affect the immune system like topical cyclosporine 
• in rare cases, when other treatments haven’t worked, oral antibiotics may be prescribed
• treatment of underlying medical conditions that may be causing or worsening your blepharitis

An online doctor can diagnose blepharitis by asking you some questions about your symptoms and examining your eyes via video link. If you have blepharitis, the doctor can advise you on home treatments and recommend or prescribe a suitable treatment if necessary. 

It’s easy to book an appointment with an NHS-trained GP at Medicspot. Simply click the link and select an appointment at a time and day that suits you. Appointments are often available the same day.

A pharmacist can help with blepharitis by recommending products to keep your eyelids clean like eye pads, wipes, and eyedrops. They can also advise you on when to see a GP. 

Find a Pharmacy Near You

Blepharitis is a common eye condition that causes inflammation of the eyelids. There is no cure for blepharitis, but symptoms can usually be managed at home. In some cases, blepharitis may need to be treated with medication. 

If you have symptoms of blepharitis and would like to talk to a doctor, make an appointment today.

American Academy of Ophthalmology: What Is Blepharitis?  August 8th 2022 (Accessed November 19th 2022) 

NHS: Blepharitis  February 8th 2022 (Accessed November 19th 2022)

PubMed: Diagnosis and management of blepharitis: an optometrist’s perspective August 8th 2016 (Accessed November 19th 2022)

National Eye Institute: Blepharitis August 31st 2020 (Accessed November 19th 2022)

Patient Info: Blepharitis August 17th 2021  (Accessed November 19th 2022)

Sage Journals: A systematic review of the effect of omega-3 supplements on meibomian gland dysfunction October 16th 2020 (Accessed November 19th 2022)