Blepharitis

The two main types of blepharitis are:

• Anterior blepharitis affects the outer edge of the eyelids where the eyelashes grow. It is often linked to bacteria, dandruff, or eyelash mites.
• Posterior blepharitis affects the inner edge of the eyelids next to the eyeball. It is often due to blocked oil glands or skin conditions such as rosacea.

Symptoms of blepharitis are usually worse in the morning. Common ones include:

• Red or watery eyes (both may occur together)
• Swollen, itchy eyelids
• Sticky or greasy eyelids
• Crust on the eyelashes
• Flaking skin around the eyes
• Burning, gritty, or stinging sensation often called eye irritation
• Frequent blinking
• Increased sensitivity to light
• Blurred vision that improves after blinking

Doctors are not sure of the exact cause. Common triggers include:

• Dry eyes
• Dandruff on the scalp and eyebrows (seborrheic dermatitis).
• Bacterial eye infection
• Blocked eyelid oil glands
• Rosacea (a skin condition with facial redness)
• Allergies (makeup, contact lens solutions, or medicines)
• Tiny mites or lice on the eyelashes

Blepharitis is usually diagnosed through: 

• A comprehensive eye examination by an ophthalmologist.
• Taking medical history to assess skin conditions (such as rosacea or seborrheic dermatitis) or allergies.
• Looking closely at the eyelids, eyelashes, and tear film. This includes looking for signs of inflammation, crusting at the base of the eyelashes, or abnormal oil gland function in the eyelids.
• Using a slit lamp (special microscope) to see eyelids, glands, and tears
• Taking a tear sample or swab (if needed) to check for bacteria, fungi, or mites

Most cases, improve with self-care: 

• Washing the eyelids regularly with a mild cleaner
• Using warm compresses

If symptoms do not resolve with self-care, doctors may prescribe:

• Infection-targeting medications such as antibiotic eyedrops, creams, or tablets (oral antibiotics)
• Anti-inflammatory medications such as steroid-based eyedrops or ointments for people who do not respond to other treatments.
• Immunomodulatory medications such as topical cyclosporine drops for more resistant cases.
• Medications to treat underlying conditions, such as rosacea, seborrheic dermatitis, or other diseases, may help alleviate the signs and symptoms.

See a doctor if you:

• Still have symptoms after home care
• Have pain, severe redness, or swelling
• Notice changes in your vision
• Keep getting eyelid infections

You can lower your risk by:

• Cleaning eyelids daily
• Using warm compresses regularly
• Avoiding old or shared eye makeup
• Treating dandruff or skin conditions
• Keeping contact lenses clean

An ophthalmologist (eye specialist) is the best doctor to treat blepharitis. In some cases, an optometrist or a dermatologist may also help.