Blepharitis is a chronic inflammation of the eyelids and is the most common cause of dry eye.  Blepharitis can cause blockage of the eyelid meibomian glands so that they stop releasing their oils. Without the oils, the tears that moisturize and protect the eyes dry up too quickly. The eyes often feel sore, itchy, and dry. 

In blepharitis, the eyelids can get flakes or crusts around the eyelashes, often worse in the morning.  The lids can be red and mildly swollen.  The blocked eyelid glands can become swollen from backup of the oily secretions that develop into a stye or a bump (chalazion).

Chalazion or stye: a blockage of a mebomian oil gland results in localized swelling and overlying skin changes

What causes blepharitis?

We don’t fully understand why blepharitis is so common. There are some association; for example, it is more common in patients who have a type of skin sensitivity called Rosacea.  However, most patients with blepharitis have no associated conditions and the normal bacteria found on the skin are thought to be involved in the inflammation in blepharitis.

Blepharitis: the eyelid margin gets red and inflamed. Deposits or crusts develop around the base of the eyelashes

Is blepharitis serious?

Fortunately, for most patients, blepharitis is a mild condition that can cause dry eye and sometimes bumps of the eyelids that come and go.  For some patients, the inflammation can be more aggressive and can involve the cornea.  This can lead to scarring and permanent vision loss if not properly treated.

It is important to have your eye care provider monitor your blepharitis to ensure it is controlled.

How to treat blepharitis?

Unfortunately, there is no cure for blepharitis. However, most patients can manage their condition with some simple at-home routines.

The first 4 steps to managing blepharitis do not involve medicines:

  1. Baby shampoo scrubs Use baby shampoo diluted in warm water and gently scrub the upper and lower eyelashes, right where they insert into the eyelid, every morning. Alternatively, you can also dedicated eyelid wipes to clean the lashes.
  2. Omega 3 Start taking omega 3 (EPA and DHA) in your diet.  Adults can take 2,000mg/day.  Smaller children can start at 500mg/day. Teenagers can take 1,000mg/day.  Omega 3 in the diet helps to soften the oils in the eyelid meibomian glands.  You can find many formulations of omega 3, including capsules, liquid and some chewable gums. Omega 3 often is derived from fish, but flax seed is a good vegetable source. Make sure you check the dosing before deciding on a product.
  3. Warm compresses 5 to 10 minutes of warmth over closed eyelids can help to soften the oils in the glands.  You can purchase moist heat compresses that are warmed in the microwave for a few seconds and then placed on closed eyelids.  Some patients make home-made versions with light weight heating pads covered in a clean moist face cloth. The compresses should be warm and comfortable, not too hot.
  4. Artificial tears If your eyes are feeling dry or irritated you can start by using an over-the-counter artificial tear up to four times daily.  You should visit your eye care provider if you find you require this on a regular basis.

When these first 4 steps are insufficient to manage blepharitis, then prescription medicines (drops, oral antibiotics) are sometimes required.  You should visit your eye care provider for an assessment to establish a customized eye care plan.

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