Blepharitis (Eyelid Inflammation): Causes, Types, Symptoms, Diagnosis & Treatment

Types Of Blepharitis

• Anterior blepharitis - It occurs on the outside of the eyelids, where your eyelashes are attached. It is caused either due to dandruff on the eyebrows or allergic reactions in the eyes [3].

• Posterior blepharitis - It occurs on the inner edge of the eyelids that touches the eyeball. Posterior blepharitis is a result of a malfunctioning oil gland. As a result, the glands become inflamed and produce excessive amounts of oil that become clogged in your eyelids. Posterior blepharitis can also occur due to acne rosacea, allergic conjunctivitis and eczema [4].

Symptoms Of Blepharitis

• Red eyes
• Watery eyes
• A burning or stinging sensation in the eyes
• Itchy eyelids
• Red, swollen eyelids
• Greasy eyelids
• Sensitivity to light
• Sticky eyelids
• A feeling that something is inside the eye
• Flaking and crusting at the base of the eyelashes.

The symptoms become worse in the morning and you experience crusting of the eyelids as you wake up [5].

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Risk Factors Of Blepharitis

• Dandruff
• Acne
• Dry skin
• Poor hygiene
• Diabetes
• Old age
• Cosmetics

Complications Of Blepharitis

• Dry eyes - When the debris and oil shed from the eyelids, they can accumulate in your tear film - the water, oil and mucus solution that form tears. This can interfere with the healthy lubrication of your eyelids eventually causing dry eyes [6].

• Sty - It is an infection that develops near the eyelash base, causing a painful lump on the outside of your eyelid.

• Eyelash problems - Blepharitis can lead to falling out of eyelashes.

• Conjunctivitis - Blepharitis can cause recurrent episodes of conjunctivitis [7].

• Eyelid skin problems - Long-term blepharitis causes scarring of the eyelids.

• Chalazion - It happens when one of the oil glands at the margin of the eyelid gets blocked, which causes the gland to become infected with bacteria [8].

When To See A Doctor

If you have the above-mentioned symptoms that are not going away, you should consult a doctor immediately.

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Diagnosis Of Blepharitis

The doctor will ask about your symptoms, medical history and examine your eyelids through some tests which include the following:

• Slit-lamp examination - Slit lamp is a low-power microscope which emits thin-beam light that allows the doctor to look outside of the eyes and eyelids.
• Swabbing skin for testing - The doctor may also use a swab to collect a sample of the oil formed in your eyelid. This sample is then analysed to see if there is any bacteria or fungi [9].

Treatment Of Blepharitis

• Eyelid hygiene - It is considered the foremost effective treatment for blepharitis. Eyelid hygiene treatment is done by applying a warm water compress on the eye for 5 to 10 minutes to clear the oil, debris and dilate the oil glands. After which, the eyelids should be gently washed by dipping a cotton ball soaked in diluted baby shampoo to eliminate the scales and debris. For treating posterior blepharitis, massage the eyelids gently with a cotton ball or finger in small circular patterns to dilate the oil glands. The eyelid hygiene treatment should be done two to four times daily [10].

• Antibiotics - Doctors will prescribe antibiotics that may treat blepharitis and provide relief from symptoms. These antibiotics are available in eye drops, cream, and ointments.

• Intense pulsed light therapy (IPL) - This treatment procedure uses pulses of light to liquefy and release hardened oils that have clogged the glands in the eyelids. IPL reduces eyelid redness and stimulates healthy gland function [11].

• Electrochemical lid margin debridement - It is a hand-held electromagnetic device that is used in the eyelid margins. It has a spinning surgical-grade sponge tip that is glided along the eyelids, and it effectively eliminates debris and biofilm, leaving the eyelid margins clean [12].

• Thermal pulsation treatment (Lipiflow) - This procedure liquefies and opens the clogged oil glands by gently heating and massaging the inner and outer eyelid. After this treatment, the oil glands resume normal oil production [13].

Prevention Of Blepharitis

• Clean your eyes regularly.
• Remove eye make up before bedtime
• Avoid touching your eyes with dirty hands.

Common FAQs

Q. Is blepharitis contagious?

A. No, blepharitis isn't contagious.

Q. What happens if blepharitis is left untreated?

A. If blepharitis is not treated, it can lead to keratopathy, corneal neovascularisation and corneal ulceration.

Q. How long does blepharitis take to clear up?

A. If blepharitis doesn't go away with eyelid hygiene management, antibiotics and steroids are used and it needs to be used as prescribed by the doctor.