What is blepharitis?

Blepharitis is a common eyelid inflammation with a complex set of causes. It is also commonly called lid margin disease because it affects only the edges of your eyelids. It can happen either when certain skin conditions cause irritation or when bacteria results in infection, or a combination.

As a result, your eyelids may become red, swollen and scaly. Blepharitis usually affects both eyes. In some cases it can only affect one eye, but this is uncommon. Once blepharitis occurs, it’s possible to also get a secondary infection. Though uncomfortable, most cases aren’t contagious and won’t cause blindness.

How common is blepharitis?

Most forms of blepharitis affect adults and children of both genders equally. However, certain forms, such as staphylococcal blepharitis, affect mainly women (80% of cases). A recent survey of ophthalmologists and optometrists reported that nearly half of the patients they see showed symptoms of blepharitis. So it’s good to know that it’s very common and the symptoms are very manageable.

Are there different types of blepharitis?

Blepharitis is defined by its location on your lids.

Two types exist:

Anterior blepharitis: occurs when the eyelid’s front exterior, where eyelashes emerge, is red and swollen.

Posterior blepharitis: perhaps the more common type, happens when the oil (meibomian) glands in the moist underside of the eyelid produce oil erratically.

What are the symptoms of blepharitis?

Blepharitis may make your eyelids feel itchy and look red, swollen and scaly. As the scales become courser, the eyelid surface becomes irritated and forms crusts, which may cause your lids to stick together. You may wake up in the morning with a crust on your eyelashes and eyelid edges that’s heavier than the “sleep” you’re used to seeing. Instead of a normal clear or white, the eye discharge may be more yellow or green in color. If the crust falls into your eye, you may feel like you have “something in your eye,” or your eye may feel gritty.

Other symptoms may include:

  • Burning sensation in eyelid area.
  • Excessive blinking.
  • Blurred vision.
  • Crusting of eyelashes and eyelid corners.
  • Dry eye.
  • Eyelids stuck together.
  • Excessive tearing.
  • Flakes of skin around eyes and eyelids.
  • Greasy eyelids.
  • Itching.
  • Photophobia (light sensitivity).
  • Red, swollen eyelids.
  • Red, irritated eyes.

What causes blepharitis?

The causes of blepharitis are not well known and there is rarely a single cause. Bacteria or conditions that cause inflammation are believed to among the culprits.

These include:

Anterior Blepharitis

  • Acne rosacea. Rosacea causes facial skin inflammation, including 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 eye. Dry tear ducts can alter bacterial resistance, resulting in infection.
  • Lice or mites in eyelashes (Demodicosis). Eyelash follicles and glands become blocked with demodex mites or lice. One study found 30% of chronic blepharitis patients had demodex mites.

Posterior Blepharitis

  • Meibomian Gland Dysfunction (MGD). Openings of oil-producing glands in your eyelids become plugged, causing dry eye, which can result in inflammation and infection. This common type may be the least preventable. Posterior blepharitis may also be triggered by skin conditions, such as rosacea or dandruff.

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