What Is Blepharitis?
Blepharitis is a common, chronic condition that involves inflammation of the eyelids, specifically around the base of the eyelashes or the oil-producing Meibomian glands. It affects people of all ages and, while it does not typically damage vision or spread from person to person, it can cause significant discomfort and visual disturbances if left untreated.
Though there is currently no permanent cure, the condition can be effectively managed with consistent eyelid hygiene and, in some cases, medication.
Types of Blepharitis
Blepharitis is categorised based on where the inflammation occurs:
- Anterior Blepharitis – Affects the front of the eyelid where the eyelashes grow. Often linked to bacterial (staphylococcal) infections or skin conditions like seborrhoeic dermatitis.
- Posterior Blepharitis – Involves the Meibomian glands at the back of the eyelids. This type is often associated with Meibomian Gland Dysfunction (MGD) and skin conditions like rosacea.
- Mixed Blepharitis – A combination of both anterior and posterior blepharitis. This is the most common form and often requires a multi-faceted treatment approach.
Signs and Symptoms
Blepharitis typically affects both eyes, though symptoms can vary in severity between them. Common symptoms include:
- Red, swollen, or itchy eyelids
- Crusting or greasiness at the base of the eyelashes
- Burning or gritty sensation in the eyes
- Light sensitivity (photophobia)
- Watery eyes or dry eye symptoms
- Eyelashes that fall out or grow abnormally
- Uncomfortable contact lens wear
- Morning symptom flare-ups
In severe or untreated cases, inflammation can lead to ulcerative blepharitis, loss of eyelashes, and even corneal involvement, including erosions or neovascularisation.
Causes and Risk Factors
Blepharitis may arise from one or more of the following:
- Bacterial infection (especially staphylococcus)
- Seborrhoeic dermatitis (flaky, oily skin)
- Meibomian gland dysfunction (MGD)
- Rosacea
- Eyelash mites or poor eyelid hygiene
- Hormonal changes or oily skin conditions
Although not contagious, blepharitis is persistent and can be exacerbated by other ocular surface diseases like allergies or dry eyes.
Treatment and Eyelid Hygiene
Blepharitis is usually a long-term (chronic) condition, and managing it requires ongoing care. The cornerstone of treatment is daily eyelid hygiene.
Daily Eyelid Care Routine:
- Warm Compresses – Apply a warm, clean towel for 5–10 minutes to soften gland secretions.
- Gentle Lid Massage – Massage the eyelids to express oils from the glands.
- Lid Cleaning – Use a recommended lid cleanser to remove crusts, bacteria, and debris.
Medication Options:
- Topical or oral antibiotics (e.g., doxycycline, tetracycline)
- Anti-inflammatory eye drops or ointments
- Omega-3 supplements or flaxseed oil to support gland health
- Long-term oral antibiotics for chronic posterior blepharitis or rosacea-related cases
With consistent care, flare-ups can be reduced, and symptoms kept under control.
Struggling with crusty, swollen eyelids or gritty eyes in the morning?
Book a consultation with Davida van der Merwe Optometrist for expert diagnosis and a personalised care plan to manage blepharitis and protect your eye health.
