Boulder Eye Surgeons
Donald J. Keller, MD & Brian E. Nichols, MD PhD

Blepharitis

Blepharitis is a common and persistent inflammation of the eyelids and eyelid margins. Symptoms include redness, irritation, and itching. Often, these symptoms are worse in the morning. Patients often complain that there is "sand" in their eyes.

blepharitis
Flakes and deposits on the lashes are typical in blepharitis.

This condition frequently occurs in people who have a fair complexion, especially in those that have other eye problems, including acne rosacea and dry eyes. Children can also be affected, and this may become a chronic problem, or it may develop later in life.

Bacteria reside on the surface of everyone's skin, but in some individuals they thrive on the skin at the base of the eyelashes along the eyelid margins. This is worsened when there is an overactivity and buildup of the oil secreted by glands in the eyelids. The result is redness of the eyelid margin, frequently with dandruff-like scales and particles along the lashes and eyelid margins.

Symptoms from the irritation and inflammation vary from minor occasional irritation and itching to redness, stinging, and burning. Some people, especially those that wear soft contact lenses, may develop an aggressive allergy to the blepharitis which can lead to inflammation and potential destruction to other eye tissues, particularly the cornea (the clear dome in the front of the eye that sits in front of the iris, the colored part of the eye).

Blepharitis may not be completely cured, but it can usually be controlled with simple daily lid scrubs. At least twice a day, use some "no-tears" baby shampoo (such as Johnson's and Johnson's©) diluted in warm water to gently scrub the eyelashes and lid margin about 15 seconds for with a washcloth, your fingertip, or a Q-tip. Use of a mild shampoo is important in removing the oily secretions from the eyelids' oil glands that have built up on the lid margins that promote bacterial overgrowth. In addition, it helps liquefy these oily secretions which helps prevent the development of a chalazion, an inflamed lump in an eyelid oil gland (see Styes and Chalazia for additional information).

Using lid scrubs will minimize the need to use additional medications to control blepharitis and its symptoms:

  • Dry eye symptoms can worsen blepharitis, and is especially common in dry climates such as Colorado. Artificial tears, which are available without a prescription, may be used to relieve the symptoms of dry eyes (see Dry Eyes for additional information).
  • A short course of steroid drops may be useful in decreasing the acute inflammation from blepharitis.
  • Antibiotic drops or ointment may also be useful to treat aggressive bacterial overgrowth. In addition, some oral antibiotics are also often useful in the treatment of severe blepharitis.
Despite these medications, effective treatment may include detailed cleaning of the lashes and lid margin with "no-tears" shampoo. Furthermore, continued cleaning of the eyelids may be necessary for long-term control of blepharitis.