Eyelid Inflammation (Blepharitis)

Blepharitis is a common eyelid disorder. It is a subacute or chronic inflammation of the eyelid margin that causes red, swollen, or itchy eyelids along with crusty, dandruff-like deposits on the eyelashes.

The eyelids are folds of skin that help protect the eyes from debris and injury. Blepharitis commonly occurs when the tiny oil glands located at the edges of the eyelids become clogged or irritated.

It is a very common condition that can occur at any age, but it is most often seen in children and adults over 50 years. It usually affects both eyes.

Although blepharitis can be uncomfortable and irritating, it is not contagious, and vision is rarely affected.

Types of Blepharitis

Depending on the location, there are two types:

Anterior Blepharitis

• Affects the outer eyelid margin, where the eyelashes are attached.

Posterior Blepharitis

• Affects the inner eyelid margin.

• Caused by dysfunction of the meibomian glands.

• It is the leading cause of evaporative dry eye.

Blepharitis often develops due to skin conditions, bacterial infection, or a combination of both.

Causes and Risk Factors

The exact cause is often unknown, but it is commonly linked to excess bacteria at the base of the eyelashes.

Other contributing factors include:

• Seborrheic dermatitis (dandruff of scalp or eyebrows)

• Bacterial infection

• Poor cosmetic hygiene

• Exposure to pollutants or chemicals

• Allergies (including reactions to eye medications or contact lens solutions)

• Meibomian gland dysfunction

• Rosacea (skin condition causing facial redness)

• Dry eye disease

Signs and Symptoms

Blepharitis often presents with:

• Yellow crusts along the eyelid margin

• Redness and thickening of the lid margin (tylosis)

• Mild conjunctival redness

• Small ulcers that may bleed when crusts are removed

Common Symptoms

• Itching and burning sensation in the eyelids

• Foreign body sensation (especially in the morning)

• Red and swollen eyelids

• Chronic irritation

• Madarosis (loss of eyelashes)

• Light sensitivity (photophobia)

• Watery eyes

• Eyelids sticking together

• Misdirected eyelashes

• Flaky lashes

• Frequent styes or chalazia

Complications of Blepharitis

Possible complications include:

• Stye (Hordeolum): Painful, red bump due to infection

• Chalazion: Painless lump caused by gland blockage

• Tear film instability

• Corneal infection due to poor oil secretion

• Difficulty wearing contact lenses

• Secondary inflammation of conjunctiva, lacrimal glands, or cornea

• Excessive tearing

• Marginal keratitis

• Tylosis (thickened eyelids)

• Conjunctivitis (pink eye)

It is also important to distinguish blepharitis from sebaceous carcinoma, a rare cancer of the eyelid.

Treatment of Blepharitis

Treatment depends on severity. Mild cases can often be managed at home.

Home Care

• Avoid rubbing your eyes

• Avoid eye makeup during active infection

• Apply warm compresses to soften crusts

• Maintain good eyelid hygiene

• Clean eyelids gently using a cotton swab with clean water and diluted baby shampoo

Medical Treatment

If symptoms persist, consult an eye specialist. Treatment may include:

• Antibiotic medication

• Anti-inflammatory or steroid drops/ointments

Prevention Tips

To reduce the risk of blepharitis:

• Remove eye makeup thoroughly before sleeping

• Avoid expired cosmetic or eye products

• Do not apply eyeliner along the inner eyelid margin

• Maintain good eyelid hygiene

• Avoid touching eyes with unclean hands

• Use glasses instead of contact lenses during flare-ups