Blepharitis

Blepharitis is a common, chronic inflammation of the eyelids that affects the skin, eyelashes, and oil glands along the lid margins. It is one of the leading contributors to dry eye disease and is often responsible for symptoms that persist despite regular use of artificial tears.

While blepharitis is not contagious or vision-threatening, it frequently requires ongoing management to keep symptoms under control.

What Causes Blepharitis?

Blepharitis develops when the delicate balance of the eyelid environment is disrupted. The most common causes include:

Meibomian gland dysfunction (MGD)
When oil glands become blocked or produce poor-quality oil, inflammation develops along the lid margins.

Bacterial overgrowth
Naturally occurring bacteria on the skin can multiply excessively, producing toxins that irritate the eyelids and tear film.

Skin conditions
Rosacea, seborrheic dermatitis (dandruff), and eczema are frequently associated with blepharitis.

Biofilm buildup
A sticky layer of bacteria and debris can form along the lash line, making inflammation more difficult to control.

Because blepharitis often has multiple contributing factors, treatment focuses on long-term control rather than a permanent cure.

Types of Blepharitis

Anterior Blepharitis

Affects the outer edge of the eyelid where eyelashes grow. It is commonly linked to bacterial overgrowth or skin conditions such as dandruff.

Posterior Blepharitis

Affects the inner eyelid, where the meibomian oil glands are located. This form is closely associated with dry eye disease and MGD.

Many patients have a combination of both types.

Common Symptoms

Blepharitis symptoms can vary in intensity and often fluctuate:

• Burning, stinging, or gritty sensation
• Red or swollen eyelid margins
• Crusting or flaking at the base of the eyelashes
• Itchy or irritated eyes
• Excessive tearing or dry eye symptoms
• Blurred vision that improves with blinking
• Frequent styes or chalazions

Symptoms are often worse in the morning or after prolonged screen use.

How Blepharitis Affects Dry Eye

Healthy oil glands are essential for a stable tear film. When blepharitis interferes with oil production or delivery:

• Tears evaporate too quickly
• Artificial tears provide only temporary relief
• Inflammation perpetuates a cycle of dryness and irritation

This is why treating blepharitis is a critical step in managing chronic dry eye disease.

Treatment Options

Blepharitis requires a consistent and individualized treatment approach.

At-Home Management

• Daily lid hygiene using lid cleansers or wipes
• Warm compresses to soften oils and reduce blockage
• Gentle lid massage to improve gland expression
• Avoiding eye makeup during flare-ups

These steps form the foundation of long-term control.

Dry Eye & Lid Treatments

For moderate to severe or persistent blepharitis, professional treatments may be recommended:

Meibomian Gland Expression Treatment
Improve oil flow and reduce gland obstruction.

Intense Pulsed Light (IPL)
Helps reduce inflammation, bacterial load, and abnormal blood vessels associated with rosacea.

Blephex Treatment
Removes biofilm, debris, and inflammatory buildup along the eyelid margins.

Prescription medications
Antibiotic, anti-inflammatory, or steroid treatments may be used during flare-ups.

Why Blepharitis Is Chronic

Blepharitis tends to recur because:

• Oil glands naturally change with age
• Skin conditions can flare unpredictably
• Environmental factors such as screens, air conditioning, and contact lenses exacerbate symptoms

With proper care, however, symptoms can be well controlled, and flare-ups can be reduced in frequency and severity.

Preventing Flare-Ups

Long-term success depends on maintaining eyelid health:

• Practice regular lid hygiene even when symptoms improve
• Treat underlying dry eye disease
• Manage skin conditions such as rosacea
• Limit eye rubbing
• Attend routine dry eye evaluations

When to Seek Professional Care

You should seek evaluation if:

• Symptoms persist despite regular lid hygiene
• Vision becomes affected
• Styes or chalazions occur frequently
• Redness or discomfort worsens

Early intervention helps prevent complications and improves long-term comfort.