Blepharitis
This page gives you information about the eye condition blepharitis, the possible causes and how to treat it.
What is blepharitis?
This is a very common chronic and persistent condition caused by inflammation of the rims of the eyelids. Prolonged treatment will be required to control the problem and make the eyes more comfortable - there is no cure.
Signs and symptoms
- Red, inflamed or oily eyelids.
- Tiny flakes or crusts on or around the base of lashes.
- Infections causing ‘sticky’ eyelids which are difficult to open in the morning.
- Blocked or infected eyelid glands causing cysts or styes (see leaflet GHPI0189 Meibomian cysts).
- Dry eyes causing gritty and burning eyes.
- Problems with contact lens wear.
- Damage to the roots of eyelashes causing the lash to grow in the wrong direction and rub or scratch the surface of the eye causing constant irritation.
What causes blepharitis?
The exact cause is unknown, but it may sometimes be associated with the following skin conditions:
- Acne rosacea
- Seborrhoeic dermatitis
- Atopic eczema
You doctor will check for these conditions and treat them if required. This will help keep the blepharitis under control.
Treatment with ‘lid hygiene’
The best treatment is careful cleaning of the eyelids and lashes. This should become a regular part of your daily routine. The best time to do this is in the morning, repeating it again in the evening if your eyes are sore.
Please follow the steps below:
Step 1 - Makeup removal
If you are wearing eye makeup, remove it with a ‘gentle’ eye make-up removal product. Always wear hypoallergenic makeup, and one which is easy to remove.
Step 2 - Heat application
Soak a clean face flannel (or makeup removing pad) in tap water - as hot as is comfortable. Apply as a hot compress to the closed eyelids for about 5 to 10 minutes using gentle pressure. You will need to rewarm the compress a number of times. This will soften any debris and crusts making them easier to remove. It will also allow oils to flow out of the glands onto the eyelids.
An alternative method of heat application is the use of a re-usable heated eye mask (either microwave or USB), available from most optometrists and pharmacies as well as on-line outlets.
Step 3 - Massage the lids
Gently hold your first finger on top of your closed eyelid and roll it up and down. This will push out any excess oils or mucous from the glands near the lashes.
Step 4 - Lid cleaning or lid scrubs
Using a face cloth or a makeup removal pad, clean the edges of your eyelids using water which has recently been boiled and allowed to cool. Do this using a side-to-side motion along the eyelids.
If debris remains after this, then you can use a moistened cotton bud to gently ‘scrub’ between the lashes.
Use a clean flannel, cotton bud or make-up removal pad each time and for each eye.
Treatment with ointment, drops and tablets
Antibiotic ointment may be prescribed if the lids are infected. Chloramphenicol 1% eye ointment is a broad-spectrum antibiotic ointment to treat red and sticky eyes. This can be purchased from your local pharmacy. The pharmacist will ask you some questions before you can purchase this antibiotic eye ointment.
The ointment should be applied to cleaned lids. Wash your hands thoroughly then place a small amount of the ointment on your fingertip. Gently rub it into the lid edges and lashes.
Rarely, low dose antibiotics taken by mouth may be prescribed for many months – particularly for patients with acne rosacea. If you need these, your doctor will give you more information.
Artificial tear drops may need to be used regularly as blepharitis is often associated with dry eyes (see leaflet GHPI0862 Dry Eye).
Please remember…. there is no cure for blepharitis but with regular treatment you should expect things to improve in 2 to 8 weeks, when you can reduce the number of times you treat the lids.
Do not stop your treatment completely, as the symptoms will recur. If symptoms do return, increase the number of treatments again.
Contact information
For any urgent problems related to blepharitis, please contact the ophthalmology triage line and speak to one of the ophthalmic nurse practitioners.
Tel: 0300 422 3578
Monday to Friday, 8:00am to 1:00pm and 2:00pm to 5.30pm
Saturday, 8.00am to 1.00pm
Further information
More information about blepharitis and eyelid disorders such as Meibomian Gland Disease and Dry Eye can be found by searching on the following websites:
NHS UK
https://www.nhs.uk/conditions/blepharitis/
Patient
https://patient.info/eye-care/swollen-eyelid/blepharitis