Blepharitis

What is blepharitis?

Blepharitis is inflammation of the edges of the eyelids. Your eyelids may look crusty, flaky, and often red. This condition is very common, especially in older adults. It does not usually affect your eyesight but can cause mild blurring that comes and goes.

How does it occur?

Causes of blepharitis include:

• bacteria, such as staphylococci, or other organisms
• a skin condition called rosacea, which causes the oil glands of the skin of the face, nose, and eyelids to become clogged

Bacteria may cause crusts and particles to form along the eyelashes of some people but not others. People who have dandruff or oily skin are more likely to have blepharitis.

What are the symptoms?

Symptoms include:

• irritation, itching, or burning of the skin at the edge of the eyelid
• crusty deposits on the edge of the eyelid that flake off
• red eyelid edges
• matted eyelashes, especially in the morning
• lashes that fall out
• dry, gritty eyes
• watery eye

How is it diagnosed?

Your healthcare provider will examine your eyes using a magnifying instrument. He or she may also examine your scalp. Sometimes a sample of the deposits from your eyelids is sent to a lab to determine if bacteria are present.

How is it treated?

Blepharitis can be difficult to treat. In general, treatment involves careful washing of your eyelids and lashes. You may need to follow a certain cleansing procedure for several weeks or months. The cleansing procedure is as follows:

• Moisten a washcloth with warm water and hold it over both eyes for several minutes. This helps to soften any deposits on the eyelids. This can also help open up the oil glands and moisturize the eye. Gently massage the eyelids with the warm washcloth for a few seconds at a time in order to help clear the plugged oil glands.
• Add a few drops of baby shampoo to a cup of water. Moisten a cotton swab with this mixture. Using the swab, clean all the deposits from your lid margins and eyelashes. Do not pull the crusts off with your fingers.

Your provider will tell you how often you should follow the cleansing procedure.

Your provider may prescribe ointment (with or without antibiotics) to help relieve your symptoms. After washing your lids and lashes, rub the ointment along the edges of your eyelids. Follow your provider's instructions carefully.

In some cases, you may need to take antibiotic pills.

How long will the effects last?

For some people, blepharitis may never completely go away. For others, cleansing and medicine may cure the problem. Even when symptoms disappear, regular cleansing may help keep blepharitis from returning.

Reviewed for medical accuracy by faculty at the Wilmer Eye Institute at Johns Hopkins. Web site: http://www.hopkinsmedicine.org/wilmer/

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