Blepharitis is inflammation, redness and scaling of the margin of the upper or lower eyelid or both, often associated with the sebaceous glands of the eyelashes and with the common skin disorder seborrhoeic dermatitis.

Blepharitis may also occur because of a bacterial infection or may be due to an allergy to cosmetics.

If you have blepharitis, your eyelids will be swollen, red and itchy. The margins of the eyelids may be covered with soft, greasy scales that dry into crusts, sticking the eyelashes together. In some cases, the roots of the eyelashes become infected, causing styes to form.

Causes of Blepharitis

Blepharitis is caused by infections that enter the eyelids through the base of the eyelashes. It can occur at all ages and the condition can become chronic.

People who have eczema and dandruff may get blepharitis, because of their general skin sensitivity. Any cosmetic preparations that reach the eyelids, for example moisturizing creams, perfumes and nail varnish may cause eczematous blepharitis, but people with eczema may get blepharitis without any obvious irritant. Similarly, blepharitis can be caused by an allergic reaction to eye make-up or skin preparations. However, often the cause is obscure.

Symptoms of Blepharitis

The edges of the eyelids are swollen, red, scaly and itchy. There may be crusting of the eyelids but, unlike conjunctivitis, this crusting tends to spare the eyes themselves. They are rarely affected and are therefore neither red nor sticky.

There may be eczema elsewhere – dry, irritant flaking skin and scalp, or dandruff. In severe cases small ulcers may develop at the root of the eyelashes and the lashes may fall out.

Treatment of Blepharitis

Work antibiotic eye drops or ointments into the eyelashes. For severe infection an antibiotic is given by mouth. If the cause is eczema, it can be very hard to treat. Consider irritants that have transferred to the lids; mild steroid creams on the lids should cure the condition. If there is dandruff, the blepharitis may be helped by using an anti-dandruff shampoo on the scalp.

  • You can relieve the symptoms by holding a clean, warm, damp cloth against the eyelid.
  • The healing process may be helped by cleaning the eyelids twice a day with baby shampoo diluted half and half with water, or you could use an over-the-counter eyelid wash.
  • If you have seborrhoeic dermatitis, treating it should also help the blepharitis.
  • If the blepharitis recurs repeatedly, see your doctor, who may prescribe topical antibiotics. The condition often clears up after 2 weeks of treatment but it may recur.
  • Allergic blepharitis usually improves on its own, but you should try to avoid contact with the substance that triggered the condition.

Good eyelid hygiene is important. Clean the eyelids twice daily with a cotton-wool bud and warm water to remove all crusts, especially before applying any ointment. Removing the crusts reduces the risk of reinfection.

Complementary Treatment

Warning: Never use aromatherapy oils near the eyes. Homeopathy – bathe your eyes with saline solution and lightly apply calendula ointment. Other therapies to try: Western and Chinese herbalism; nutritional therapy; naturopathy; chakra balancing; Ayurveda.

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