Blepharitis is a common eye condition that causes chronic inflammation of the eyelids, especially around the base of the eyelashes. It can affect people of all ages, from children to older adults, and is often associated with discomfort, irritation, and visible changes to the eyelid area. While blepharitis isn’t usually dangerous or contagious, it can be persistent and frustrating if not treated properly.

In this in-depth guide, we explore the types, symptoms, causes, and treatment strategies for blepharitis—along with practical advice for preventing recurrences and maintaining long-term eye health.

Types of Blepharitis

Blepharitis is generally categorized based on where it occurs and what triggers it. Understanding the type is key to guiding treatment.

Anterior Blepharitis This type affects the outer portion of the eyelid, near the eyelashes. It's often caused by:

  • Bacterial infection (e.g., staphylococcus bacteria)
  • Seborrheic dermatitis, a skin condition that leads to flaking, similar to dandruff
  • Allergic reactions to cosmetics, environmental triggers, or allergens

Posterior Blepharitis This form occurs at the inner eyelid, the part that touches the eyeball. It is commonly associated with:

  • Meibomian gland dysfunction (MGD), where the oil-producing glands don’t function properly
  • Rosacea, a skin disorder that causes facial redness and inflammation
  • Hormonal imbalance or systemic inflammation

It is also possible to have both types simultaneously, making symptoms more severe and treatment more complex.

Common Symptoms

The severity and combination of symptoms can vary widely from one person to another. People with blepharitis often report the following:

  • Itching or burning sensation in the eyes
  • Watery eyes or excessive tearing
  • Red, swollen eyelids
  • Crusting or flaking around the base of the eyelashes
  • Gritty or sandy feeling, like something is stuck in the eye
  • Sensitivity to light (photophobia)
  • Foamy tears
  • Sticky eyelids upon waking
  • Dryness and frequent blinking

In advanced or untreated cases, symptoms can progress to:

  • Blurred vision
  • Eyelash loss or misdirected lashes (trichiasis)
  • Swelling in the cornea or other parts of the eye
  • Chronic conjunctivitis

What Causes Blepharitis?

Several underlying causes may contribute to the onset and recurrence of blepharitis. These include:

  • Bacterial overgrowth: A buildup of bacteria at the lash line can trigger inflammation.
  • Sebaceous gland dysfunction: When glands at the eyelid margins become clogged, oil production is impaired.
  • Demodex mites: These microscopic mites live in eyelash follicles and may exacerbate inflammation.
  • Environmental allergens: Pollen, dust, smoke, or chemical exposure can provoke eyelid irritation.
  • Skin disorders: Conditions like seborrheic dermatitis, eczema, and rosacea are often linked with blepharitis.
  • Contact lens overuse: Wearing contacts for prolonged periods without cleaning can irritate the eyelids.
  • Hormonal changes: Shifts in hormones, especially during puberty or menopause, can disrupt gland function.

Risk Factors

You may be more likely to develop blepharitis if you:

  • Have rosacea or seborrheic dermatitis
  • Suffer from chronic dry eye
  • Have oily skin
  • Use eye makeup regularly without proper cleaning
  • Wear contact lenses often or improperly
  • Have a weakened immune system
  • Are exposed to dusty or polluted environments
  • Have allergies or asthma

Genetics and lifestyle habits, such as diet and personal hygiene, can also play a role.

Diagnosis

To diagnose blepharitis, a comprehensive eye exam is essential. You’ll typically see an optometrist or ophthalmologist, who will:

  • Examine the eyelids and eyelashes using a magnifying lamp
  • Use slit-lamp biomicroscopy to detect inflammation or signs of clogged glands
  • Assess the quality of your tears, as blepharitis often coexists with dry eye
  • Review your medical history, including skin conditions or medication use

In some cases, your doctor may collect samples from the eyelid margin to test for bacteria or mites under a microscope.

How Is Blepharitis Treated?

Treatment focuses on relieving symptoms and addressing any underlying cause. Since blepharitis is often chronic, long-term management is key.

Daily Eyelid Hygiene Maintaining cleanliness is the first line of defense.

  • Wash eyelids twice daily using a clean cloth and warm water
  • Use gentle cleansers like diluted baby shampoo or specially formulated lid scrubs
  • Apply warm compresses for 5–10 minutes to soften crusts and unclog glands
  • Gently massage the eyelids in circular motions to stimulate oil flow
  • Avoid wearing makeup or remove it thoroughly before bed

Medications Your eye care provider may prescribe:

  • Antibiotics: Eye drops, ointments, or oral antibiotics if a bacterial infection is present
  • Steroid eye drops: Reduce swelling and severe inflammation
  • Artificial tears: Help relieve dryness and irritation
  • Immunomodulating agents: For people with underlying autoimmune skin conditions
  • Topical ointments: For coexisting rosacea or seborrheic dermatitis

Advanced Therapies For persistent cases:

  • Lid debridement using mechanical tools to remove biofilm and debris
  • Intense pulsed light (IPL) therapy for meibomian gland dysfunction
  • Thermal pulsation devices like LipiFlow to open blocked glands

Preventing Blepharitis

Though not always preventable, consistent habits can significantly reduce flare-ups:

  • Maintain strict eyelid hygiene even after symptoms improve
  • Replace old cosmetics regularly and avoid sharing them
  • Clean contact lenses properly and avoid extended wear
  • Use humidifiers to reduce dryness in the air
  • Manage skin conditions such as acne, dandruff, or rosacea
  • Avoid allergens or irritants when possible

If you’re prone to blepharitis, regular check-ups with your eye care provider can catch early signs and prevent worsening.

Complications to Watch For

Without treatment, blepharitis may lead to other eye and eyelid issues:

  • Styes: Red, painful bumps on the eyelid due to blocked oil glands
  • Chalazion: Painless, hard lump from chronic gland blockage
  • Chronic conjunctivitis: Ongoing inflammation of the eye’s outer membrane
  • Dry eye syndrome: Poor-quality tears increase irritation
  • Corneal damage: Inflammation or ingrown lashes may injure the cornea

Long-term blepharitis may also result in cosmetic changes, such as discoloration or thickening of the eyelid margins.

Living With Blepharitis

For many, blepharitis is a lifelong condition that requires routine care and patience. The key is consistency—maintaining your eye hygiene regimen and following through with treatment plans.

Tips for Daily Management

  • Stick to a scheduled cleaning routine, especially in the mornings and evenings
  • Avoid eye irritants such as smoke or strong winds
  • Use sterile eyelid wipes when traveling
  • Stay hydrated and consume a balanced diet rich in omega-3s for eye health

Let your eye care provider know if symptoms worsen or become recurrent, as new treatments or adjustments may be needed.