Blepharitis

Pronounced: Bleff-uh-REYE-tis

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Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention | Organizations

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Definition

Blepharitis is inflammation of the eyelid. It is a very common eye disease that affects the edge of the eyelids and eyelash hair follicles. There are three main types of blepharitis:

Seborrheic Blepharitis – Skin cells shed more rapidly than normal due to a sebaceous gland that is not functioning properly. The sebaceous gland secretes oil to the skin. The presence of excess oil and skin cells help bacteria to grow.

Infectious Blepharitis – Bacteria cause an infection in the glands along the eyelid.

Contact Dermatitis Blepharitis – Something coming in contact with the eyelid leads to local inflammation. For example, mascara may produce such an allergic reaction.

Causes

The primary types of blepharitis are caused by either a skin condition or an infection. Blepharitis often occurs along with seborrheic dermatitis and acne rosacea.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Seborrheic dermatitis
• Acne rosacea
• Diabetes
• Contact allergies

Symptoms

Symptoms depend on the cause of the blepharitis. They are usually worse in the morning.

Symptoms may include:

• Redness, flaky skin, and oily secretions along the edge of the eyelid
• Crusty material clinging to the eyelashes
• Dry scales or dandruff on the scalp and eyebrows
• Itching or burning sensation
• Tearing
• Sensation of a foreign object in the eye
• Ulcers or sores at the base of the eyelashes (in severe cases)
• Scant, broken eyelashes
• Chalazions (nonpainful bumps in the eyelid), which may become infected (called a stye)
• Conjunctivitis (occasionally)

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Initially you may not have any tests. If the inflammation looks unusual for blepharitis or fails to respond to treatment, the doctor will culture the eye, by passing a swab across the edge of the lid. The swab is sent to a lab to see if bacteria grow and if so, what kind. If the condition lasts for a month or more, a tissue sample may be removed for testing.

Treatment

Blepharitis is a chronic condition that often requires long-term management. Treatment depends on the cause of the condition. Do not wear contact lenses until the blepharitis has resolved.

Hygiene

In mild cases, careful, daily eyelid hygiene may bring the inflammation under control:

• Thoroughly wash your hands before performing any eye care.
• Run a washcloth under warm water.
• Place the warm washcloth on your eyelids for 5-15 minutes. This warm compress helps to loosen crust.
• With your eyes closed, wash the eyelids with a special eyelid cleanser or diluted baby shampoo. Use a different washcloth or cotton-tipped applicator for each eye.
• Rinse with cool water.

Medication

If an infection is causing the blepharitis, you will be given antibiotic eye ointment. Wash your eyelids as described above and apply the ointment with a cotton-tipped applicator. For a mild case, you may only need ointment at bedtime. If the infection is more severe, you may need to apply the ointment up to four times daily. You may need to apply the ointment nightly to prevent another episode. If blepharitis returns after topical treatment, you may be given oral antibiotics, though this is rarely necessary.

Prevention

If you are susceptible to blepharitis, conscientious eyelid hygiene can help prevent a recurrence:

• Always wash your hands before touching your eyelids
• Wash your hair and face daily
• Wash your eyelids nightly as described above

Organizations

The American Optometric Association
http://www.aoanet.org

American Academy of Family Physicians
http://www.aafp.org

SOURCES:

Griffith's 5-Minute Clinical Consult, 2001 ed. Lippincott Williams & Wilkins, 2001.

Principles and Practice of Infectious Diseases, 5th ed. Churchill Livingstone, Inc., 2000.

Cecil Textbook of Medicine, 21st ed. W.B. Saunders Company, 2000.

Goroll: Primary Care Medicine, 4th ed. Lippincott Williams & Wilkins, 2000.

American Academy of Family Physicians

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Last reviewed September 2001 by Medical Review Board