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What is blepharitis?
Blepharitis, pronounced bleh-fur-RY-tis, means inflammation of the eyelid. The edges of your lids turn red or dark in color and become swollen and scaly. Blepharitis usually affects both eyes. It can happen when a skin condition causes irritation, when you develop an infection or when oil glands become clogged. All of these things can even happen at once.
Blepharitis is a term for inflammation, but it can lead to an infection in your eye. However, most cases of blepharitis aren’t contagious. They aren’t likely to lead to blindness.
How common is blepharitis?
A survey of ophthalmologists and optometrists reported that nearly half of the people they see showed symptoms of blepharitis. The condition is common and symptoms are manageable.
Blepharitis typically affects adults and children of both sexes equally. However, one form — staphylococcal blepharitis — mainly affects women and people assigned female at birth (AFAB). This is true of about 80% of cases.
Are there different types of blepharitis?
There are two types of blepharitis, depending on where it’s located on your eyelids. They are:
Anterior blepharitis: This type occurs when your eyelid’s front exterior, where the eyelashes come out of your lids, is red or darker in color and swollen, or when you have dandruff on your lashes.
Posterior blepharitis: This type happens when the oil-producing meibomian glands under your eyelid produce thickened/unhealthy oil.
Symptoms and Causes
What are the signs and symptoms of blepharitis?
There are several signs and symptoms of blepharitis. They may include:
Swollen eyelids and/or greasy eyelids.
Red, irritated eyes that itch or burn.
Crusting of eyelashes and eyelid corners, making your eyelids stick together.
Flakes of skin collecting around your eyes and eyelids.
Dry eye or excessive tearing.
Excessive blinking.
Other signs and symptoms may include:
Photophobia (light sensitivity).
Blurred vision.
Loss of eyelashes.
Eyelashes that grow toward your eyes rather than away from them (trichiasis).
What causes blepharitis?
Blepharitis can happen if you have issues with the meibomian glands that produce the oils found in tears, certain skin conditions or infections.
Causes of anterior blepharitis
Acne rosacea: Rosacea causes facial skin inflammation, which can include your eyelids.
Allergies: Allergies to contact lens solution, eye drops or makeup can spur irritation.
Dandruff (seborrheic dermatitis): Dandruff flaking can irritate eyelids and cause inflammation.
Dry eyes: Dry tear ducts can alter bacterial resistance, resulting in infection.
Lice or mites in eyelashes (demodicosis): Lice or Demodex mites can block eyelash follicles and glands in your eye. One study found that 30% of people with chronic blepharitis had Demodex mites.
Causes of posterior blepharitis
Meibomian gland dysfunction (MGD): When the oil from meibomian glands doesn’t flow freely, you can develop dry eye, which can result in inflammation and infection.
Acne rosacea.
Dandruff.
The symptoms you have may indicate a particular type of blepharitis: staphylococcal, seborrheic, ulcerative or meibomian. For instance:
Seborrheic blepharitis has symptoms that include greasy flakes.
Ulcerative blepharitis may cause bleeding when you remove crusts.
Meibomian blepharitis causes your tears to be of poor quality.
Staphylococcal blepharitis symptoms may include missing eyelashes or lashes that point the wrong way.
What are other risk factors for developing blepharitis?
In addition to having rosacea and dandruff, you may be more at risk of developing blepharitis if you:
Have diabetes.
Wear contact lenses.
Are exposed to irritants like dust and chemicals.
Work or live in dry environments. This includes spending a lot of time in air conditioning.
Have a high number of microbes that normally live on your skin.
Don’t remove makeup thoroughly.
Have oily skin.
Are on certain drugs such as those for cancer treatment.
Are going through menopause or hormonal changes.
Do poor hygiene habits cause blepharitis?
Poor hygiene can be a factor in blepharitis, but it’s not as simple as saying that only people with poor hygiene can get blepharitis. Hygiene is just a part of the reason that some people get blepharitis.
If you think about it, most people don’t clean their eyelids and lashes every day or night. However, people with risk factors may have to make eyelid and eyelash hygiene a priority.
Diagnosis and Tests
How is blepharitis diagnosed?
There’s no single test for blepharitis. Here are a few steps your eye care provider may take to find out if you have blepharitis and what type it is:
Take a health history: The provider will ask about symptoms and other health conditions to determine your risk factors.
Do an external eyelid exam: The appearance of your eyelids and intensity of red
