Blepharitis refers to inflammation of the eyelids and eyelashes causing red, irritated and itchy eyelids. There is often an associated deposition of dandruff-like scales on the eyelashes. This is probably the commonest eye disorder, present more frequently in those over 50 years old, although it can occur at any age. 
Blepharitis is often caused by bacteria which are normally found on eyelid skin.

Blepharitis may be classified into two types:

Anterior blepharitis occurs at the front edge of the eyelid, near the skin, where the eyelashes are attached.
Posterior blepharitis affects the inner edge of the eyelid margin.

The eyelid margin contains approx. 40 glands which produce an oily secretion called mebum. These meibomian glands can get blocked as the oily secretions solidify. This results in a deficiency of the important oily component of the tear film, hence impairing the lubrication of the ocular surface. 

Individuals who have blepharitis may experience a gritty or burning sensation in their eyes, with excessive watering, itching, red and swollen eyelids. There may be crusting of the eyelids and it is often associated with dry eye. Whilst blepharitis causes only minor irritation and itching for some people, for others it can lead to more severe symptoms such as blurring of vision, missing or misdirected eyelashes, and inflammation of other parts of the eye, such as the cornea.



This procedure should be performed twice daily:

  • Take a cotton pad (e.g. make-up removing pad) in each hand and soak in reasonably hot water. Squeeze the cotton pads and place one on each closed eye for three to four minutes, keeping the cotton pads warm by periodically soaking them in the hot water.
  • Following this, place a small drop of cleaning agent (such as Blephasol) on each cotton pad and squeeze allowing the solution to lather.
  • Next, rub the cotton pads along the rim of the lower eyelids. Rub also, along the closed eyelids from inside to out, removing any dry flakes. Repeat five times.
  • Once this has been done, rinse off your face with clean warm water.
  • Please reduce the use of mascara or eyeliner. When using makeup, please clean the lids particularly carefully.

What is the basis of the treatment?

Eyelid hygiene is the mainstay of treatment and should be performed twice daily for the first 2-3 weeks and then at least once daily indefinitely to keep the inflammation under control.

There are 3 steps needed for effective lid hygiene:

  1. Heat application
  2. Massage
  3. Cleaning

Heat application:

Heat applied to the eyelids for 5 minutes:

Softens the skin and any crusts attached to the eyelids

Helps to unplug the ducts of the meibomian glands

The traditional method is to apply a hot moist flannel or cotton pad to the closed eyelids. This can be somewhat tedious because the flannel/cotton wool cool quickly and need to be repeatedly heated up in warm water

The EyeBag™ is a much more convenient and effective method of heat application because it supplies sustained warmth for 5-10minutes.

Other measures which may sometimes be helpful, include:

  1. Antibiotic eye ointment
  2. Antibiotic tablets
  3. Steroid eye ointment
  4. Omega - 3 containing foods, or dietary supplements

Both the EyeBag™ and Blephasol can be obtained from :

Face & Eye Clinic - 0161 947 2720

What is blepharitis?

Blepharitis is a very common infection/inflammation of the eyelids caused by bacteria that live normally on our skin producing irritating chemicals. As a result special tear glands, called meibomian glands, located in the eyelids, get blocked up. Since these glands help to make our tears, blepharitis results in the production of abnormal tears. This is not a lack of tears, but tears that are of poor quality. It is known that blepharitis is often associated with skin problems such as dandruff and dermatitis.

How do I know if I have blepharitis?

You will know that you have blepharitis if the rims of the eyelids are red and little crusts stick the eyelashes together. The whites of the eyes are often red and sore. In the mornings the eyelids stick together, sometimes with a yellow discharge. These changes cause the eyes to be sore and irritable, with a gritty foreign body feeling. Watering of the affected eye is common.

Is it serious?

No, it is not serious, and only very rarely causes any permanent damage to the eyes. However, blepharitis is a very persistent problem. (Blepharitis which is confined to the eyelid(s) on one side only should however be viewed with suspicion as very rare tumours can mimic blepharitis and lead to misdiagnosis).

Can it be treated?

Yes, though treatment can usually only control the problem, and cannot eradicate it altogether.

What is the treatment?

The chief treatment is massage of the eyelids and application of heat in a controlled fashion.

Click here for Lid Hygiene instructions.

What is the purpose of this heat & massage treatment?

The heat melts the tears stuck in the blocked up tear glands. Along with the pressure, this helps to unblock the glands, so that your tears become normal. Wiping the eyelashes gets rid of the crusts and the bacteria.

How often should I do this?

Depending on how bad your blepharitis is, you may need to massage the eyelids twice a day, or more often, regularly.

Anything else I can do?

After the hot massage, take some fresh cleaning pads and add a few drops of specialized eyelid cleaning solution (e.g. Blephasol) and use the detergent properties of this to clean and unblock the meibomian gland openings, on the eyelid margins.

Is that all I have to do?

In addition to regular massage, an antibiotic ointment e.g. Chloramphenicol, rubbed into the lashes at night, can clear the infection. A course of ointment, usually for a month, can be repeated several times a year. Ointments/drops containing steroids should not be used unless prescribed by an ophthalmologist.

Since blepharitis causes tears to be abnormal, artificial tears can give relief from irritation, even when your eyes are watering (eyes can water as a reflex reaction to a basic dry eye problem or tear film abnormality). These should be used 3-4 times a day at least to prevent symptoms rather than to just relieve symptoms. There is a large variety of artificial tear preparations to choose from, including:

Preservative free (PF) - these are more expensive but should be used when artificial tears are required more than 4 times a day :

Hyabak, Hylotears, Systane drops PF, Viscotears PF, Liquifilm tears PF, Celluvisc drops, or Minims artificial tears

With preservatives :

Systane, Viscotears, Hypromellose, Liquifilm tears, SNO tears.

Lacrilube ointment is very effective at night but can cause blurring of vision in the  morning.

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