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Blepharitis is an eye condition characterized by an inflammation of the eyelids which causes redness, itching and irritation. The common eye condition is caused by either a skin disorder or a bacterial infection. Blepharitis is generally not contagious and can affect patients of any age. While it can be very uncomfortable, it usually does not pose any danger to your vision.

There are two types of blepharitis: anterior and posterior.

Anterior blepharitis occurs on the front of your eyelids in the area where the eyelashes attach to the lid. This form is less common and is usually caused by a bacterial infection or seborrheic dermatitis, which is a skin disorder (dandruff) that causes flaking and itching of the skin on the scalp and eyebrows. While it is more rare, allergies or mites on the eyelashes can also lead to this condition.

Posterior blepharitis occurs on the inner eyelid that is closer to the actual eyeball. This more common form is often caused by rosacea, dandruff or meibomian gland problems which affect the production of oil in your eyelids.

Symptoms of Blepharitis

Blepharitis can vary greatly in severity and cause a variety of symptoms which include:

  • Red, swollen eyelids
  • Itching
  • Burning or gritty sensation
  • Excessive tearing
  • Dry eyes
  • Crusting on eyelids

If left untreated, symptoms can become more severe such as:

  • Blurred vision
  • Infections and styes
  • Loss of eyelashes or crooked eyelashes
  • Eye inflammation or erosion, particularly the cornea
  • Dilated capillaries
  • Irregular eyelid margin

Blepharitis Treatment Options


Soak a clean face cloth in tap water that is as warm as possible without inducing further irritation. Wring out excess water and place the warmed face cloth over the affected area. The warmth and moisture of the hot compress will tend to decrease tenderness, increase comfort and increase blood circulation in the affected area which is needed for healing. Repeat this procedure often in the early stages of treatment and gradually reduce frequency as your symptoms decrease. Hot compresses should be for at least 5 minutes for effective treatment. To help patients with this, we have Eye Compress Treatment Packs® available for purchase.


A physical massage of the upper and lower eyelids is often helpful to stimulate oil glands, called meibomian glands, inside the eyelids. These glands are responsible for producing important lubrication of the ocular surface. Due to many factors, including environmental influences, some of these glands can decrease oil production or even become blocked. A decrease in production may cause dry eye symptoms and crusty lid margins. Blocked glands may also cause discomfort and localized redness of the eyelid or eyelid margin.

Using clean fingertips physically massage your eyelids with frequency. This can also be preceded by a warm compress. If eyelid redness is localized, the massage can be done with a single finger placing back-and-forth pressure on the affected area.

We are generally not taught to scrub or rub our eyelids, however a gently daily hygiene massage in the shower is a good daily habit to maintain optimum eyelid function.


Cleansing therapy treatments to the eyelids and surrounding areas of the eyebrows and even the scalp can remove toxins and increase normal secretions from glands within the eyelids. Commercial eyelid cleaners are specifically designed for the delicate tissues of the eye. If eyelid scrub solutions or foams are not available diluted no tears baby shampoo may be substituted.

With your eyes closed, scrub each eye using side-to-side strokes for approximately 15 seconds. Be careful not to rub your eye directly but get as close to the eyelash line as possible. Rinse with warm tap water and pat dry. Repeat this procedure twice daily. Call my office if you experience excessive irritation from this procedure.

Although there may be no direct relationship to the causes of conditions that necessitate eyelid hygiene techniques, it is also prudent in more advanced cases to wash hair daily with dandruff control shampoo.


Lubricating eye drops and gels improve the lubrication of the eye as the eyelid blinks over the front surface of the eye. A gel has a higher viscosity than a drop and comforts the eye for a longer period of time. The consistency of lubrication drops, and especially gels, may blur vision temporarily. Since your diagnosis requires the use of these lubricating products to comfort your eyes they may be used at regular intervals during the day, evening, and are especially helpful before bedtime. It is important to note that it is generally not recommend using solutions that also include properties that claim to remove ocular redness.


While artificial tears can reduce dry eye symptoms, they do not cure the dry eye condition. Certain nutrients can also increase the quantity and quality of tears. Specifically, these include omega fatty acids and antioxidants. It is difficult to achieve therapeutic levels of these nutrients in the diet so supplementation is usually necessary. I will be pleased to recommend specific products for this nutritional supplementation. Nordic Naturals® Fish Oil Supplements 2,500 mg are a great source of omega 3 and do not have a fishy aftertaste.


Avenova® is an ophthalmic spray that can reduce dry eye symptoms when used twice a day for a long period of time. Many times this medication will take 1-3 weeks before any appreciable improvement is noticed.

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