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What is blepharitis?

Blepharitis is chronic inflammation of the margins of the eyelids. It can involve the eyelids, eyelashes, conjunctiva (whites of the eye) and the meibomian glands (those that lubricate the eye).

What are the symptoms and signs?

Generally there is a persistent and unsightly redness and scaliness of the skin on and around the eyelid margins. Other problems may include:


  • persistent soreness of the eyelids or eyes

  • greasy appearance of the eyelid margins

  • flakes of skin, like dandruff

  • eyelashes that fall out

  • small ulcers on the eyelid

  • crusting and bleeding (if severe)

  • irritation of the eye (from flakes)

  • sensation of ‘something in the eye’

  • grittiness, burning, itching and dryness

  • discharge from the lids, causing lashes to glue together during sleep

  • sensitivity to light

  • swelling of the eyelids and conjunctiva.

What are the three main causes or types?

  • Seborrhoeic blepharitis: associated with seborrhoeic dermatitis

  • Rosacea blepharitis: associated with rosacea of face

  • Staphylococcus blepharitis: due to infection with the bacterium Staphylococcus aureus

What are the complications of blepharitis?

Apart from infection with Staphylococcus any of the following can occur:


  • styes (infection of an eyelash)

  • meibomian cyst infection

  • conjunctivitis

  • ulceration of the conjunctiva (white of eye) or cornea (clear covering of eye)

  • loss of eyelashes

  • scarring of eyelids

  • misdirected eyelash growth (e.g. inwards).

What is the expected outcome?

Blepharitis is a chronic inflammation that is stubbornly resistant to treatment. It can be controlled and sometimes cured in about 6 to 12 months but tends to recur.

What is the treatment?

  • Eyelid hygiene is the key to successful treatment. The crusts and other debris on the eyelids should be gently cleaned with a cotton bud dipped in clean, warm water, a weak solution of sodium bicarbonate (baking soda) or a 1 in 10 dilution of baby shampoo. This should be done once or twice daily depending on the severity. An alternative is to apply a warm water or saline soak with gauze for 20 minutes followed by a rest for 60 minutes before bathing the eyelids again.

  • Control scalp seborrhoea with antidandruff shampoo (e.g. Head & Shoulders shampoo).

  • Eye lubricants such as artificial tear preparation will relieve the symptoms of dry eyes.

  • Avoid wearing eye makeup while inflammation is present.

  • Discontinue wearing contact lenses until the condition has cleared.

++ Medication

  • Short-term use of a cortisone eye ointment applied to the margins after washing will give relief.

  • Antibiotic ointment should be smeared on the lid margin regularly if infection is present.

  • Your doctor may prescribe a combined cortisone ...

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