Monday, Feb 1, 2021 by Nisha Gupta, MD

This month we will expand on our discussion from last month on styes and chalazia. Our topic will be blepharitis.

What is blepharitis?

Blepharitis is inflammation of the eyelids and eyelashes. There are two types based on where the inflammation is: anterior and posterior. Anterior affects the eyelids and base of the eyelashes while posterior affects glands called meibomian glands. Meibomian glands line the edge of the eyelid behind the eyelashes and secrete oils to keep our eyes lubricated. There can be an overlap between the two and one can have symptoms from both at the same time.

What are the symptoms?

  • Red, swollen eyelids
  • Itchy eyelids
  • Flaking, like dandruff, on eyelashes
  • Crusting on eyelids
  • Burning
  • Tearing
  • Sensation of something in the eye
  • Blurred vision

What does blepharitis look like?

On exam, doctors often see swollen and red eyelids. There may be flakes and other particles at the base of the eyelashes. Some types cause the eyelashes to turn inwards toward the eye. The meibomian glands are typically clogged in posterior blepharitis.

What are the treatments?

Warm compresses: These are a good conservative method to keep the eyelid glands open and relieve lid symptoms. The warmth of the compress will open any blockages. One can warm a washcloth with very warm water. Another option is to put a small amount of uncooked rice in a bowl and microwave it for 10-20 seconds until it is warm. The rice can be put in a washcloth and held on the eyelid. There are also eye masks sold in stores that contain beads which heat up in the microwave. The most important thing is to ensure that the cloth is not too hot as the eyelid skin is thin and can burn. It is most useful to apply the warm compresses several times a day for 5-10 minutes.

Lid scrubs: It is important to keep the eyelids clean from debris and dirt that collects in the lashes. This can be done by taking a small amount of baby shampoo and gently rubbing the eyelids with clean fingers. Wash with warm water. Another option is to purchase a cloth scrub that contains a soap.

Lubricating drops: These are eye drops that are like your own tears. These may be used throughout the day if there are any dry eye symptoms.

Prescription medications: Doctors may prescribe antibiotic or steroid eye drops to help relieve the flaking and other symptoms. Some also use oral antibiotics that are especially good for inflammation.

Omega 3 vitamins: Studies have shown that these vitamins can help with inflammation and dryness.

Other tips: Take care of other dermatological conditions such as acne rosacea and seborrheic dermatitis. These are common among patients with blepharitis.

Return next month for a discussion on a new topic!

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