Blepharitis

The information provided in this Resource Guide was developed by the National Eye Institute (NEI) to help patients and their families in searching for general information about blepharitis. An eye care professional who has examined the patient's eyes and is familiar with his or her medical history is the best person to answer specific questions.

Other Names

Granulated eyelids.

What is blepharitis?

Blepharitis is a common condition that causes inflammation of the eyelids. The condition can be difficult to manage because it tends to recur.

What causes blepharitis?

Blepharitis occurs in two forms:

Anterior blepharitis affects the outside front of the eyelid, where the eyelashes are attached. The two most common causes of anterior blepharitis are bacteria (Staphylococcus) and scalp dandruff.

Posterior blepharitis affects the inner eyelid (the moist part that makes contact with the eye) and is caused by problems with the oil (meibomian) glands in this part of the eyelid. Two skin disorders can cause this form of blepharitis: acne rosacea, which leads to red and inflamed skin, and scalp dandruff (seborrheic dermatitis).

What are the symptoms of blepharitis?

Symptoms of either form of blepharitis include a foreign body or burning sensation, excessive tearing, itching, sensitivity to light (photophobia), red and swollen eyelids, redness of the eye, blurred vision, frothy tears, dry eye, or crusting of the eyelashes on awakening.

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What other conditions are associated with blepharitis?

Complications from blepharitis include:

Stye: A red tender bump on the eyelid that is caused by an acute infection of the oil glands of the eyelid.

Chalazion: This condition can follow the development of a stye. It is a usually painless firm lump caused by inflammation of the oil glands of the eyelid. Chalazion can be painful and red if there is also an infection.

Problems with the tear film: Abnormal or decreased oil secretions that are part of the tear film can result in excess tearing or dry eye. Because tears are necessary to keep the cornea healthy, tear film problems can make people more at risk for corneal infections.

How is blepharitis treated?

Treatment for both forms of blepharitis involves keeping the lids clean and free of crusts. Warm compresses should be applied to the lid to loosen the crusts, followed by a light scrubbing of the eyelid with a cotton swab and a mixture of water and baby shampoo. Because blepharitis rarely goes away completely, most patients must maintain an eyelid hygiene routine for life. If the blepharitis is severe, an eye care professional may also prescribe antibiotics or steroid eyedrops.

When scalp dandruff is present, a dandruff shampoo for the hair is recommended as well. In addition to the warm compresses, patients with posterior blepharitis will need to massage their eyelids to clean the oil accumulated in the glands. Patients who also have acne rosacea should have that condition treated at the same time.

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Other Resources

The following organizations may be able to provide additional information on blepharitis:

American Optometric Association
243 N. Lindbergh Boulevard
St. Louis, MO 63141
(314) 991-4100
http://www.aoanet.org
Publishes an information sheet called Answers to your questions about: Blepharitis

American Academy of Ophthalmology
P.O. Box 7424
San Francisco, CA 94120-7424
(415) 561-8500
Distributes a fact sheet on blepharitis for patients. The fact sheet is available in both English and Spanish.

For additional information, you may wish to contact a local library.

Medical Literature

Below is a sample of the citations available in MEDLINE, a comprehensive medical literature database coordinated by the National Library of Medicine (NLM). MEDLINE contains information on medical journal articles published from 1966 to the present. You can conduct your own free literature search by accessing MEDLINE through the Internet at http://medlineplus.nlm.nih.gov. You can also get assistance with a literature search at a local library.

To obtain copies of any of the articles listed below, contact a local community, university, or medical library. If the library you visit does not have a copy of a particular article, you may usually obtain it through an inter-library loan.

Please keep in mind that articles in the medical literature are usually written in technical language. We encourage you to share any articles you order with a health care professional who can help you understand them.

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Meibomian gland dysfunction. Driver PJ; Lemp MA. Eye Institute at Cooper Hospital/University Medical Center, Camden, NJ. Survey of Ophthalmology 40(5):343-67, March-April 1996.
This article concentrates on posterior blepharitis that usually involves disorders of the meibomian glands. The article provides information on the history of meibomian gland dysfunction and also describes the population most commonly affected, symptoms of gland dysfunction and associated conditions. Problems that can affect the meibomian glands including the role bacteria and other organisms play in meibomian gland dysfunction are described. Treatments such as lid hygiene and antibiotics are also discussed.

Chronic blepharitis: a review. Smith RE; Flowers CW Jr. Department of Ophthalmology, University of Southern California, School of Medicine, Los Angeles, CA. Contact Lens Association of Ophthalmologists, Inc. Journal 21(3):200-7, July 1995.
This article discusses various classification systems for blepharitis, explains the possible causes of blepharitis and details the methods of treatment for both anterior and posterior forms of this difficult-to-treat disorder.

Blepharitis. Raskin EM; Speaker MG; Laibson PR. Cornea Services, New York Eye and Ear Infirmary, New York, NY. Infectious Disease Clinics of North America 6(4):777-87, December 1992.
This article starts by describing blepharitis and its symptoms. The article explains different types of classifications for blepharitis, associated disorders (such as chalazion), other diseases that can be confused with blepharitis, possible causes of blepharitis, and the various treatments available.

The National Eye Institute (NEI), part of the National Institutes of Health (NIH), is the Federal government's principal agency for conducting and supporting vision research. Inclusion of an item in this Information Resource Guide does not imply the endorsement by the NEI or the NIH.