Blepharitis is a chronic inflammation of the eyelids. A common problem in both children and adults, blepharitis causes swelling, itching and irritation of the eyelids. There are two types of blepharitis: seborrheic and Staphylococcus (staph).


The eyelid

The outer layer of the eyelid is composed of skin, while the inside of the eyelid is lined with moist tissue. Muscles and glands are located between the skin and the moist lining. The eyelashes are located on the eyelid margins, the area which come together when the eyelid is closed. Tiny openings from which glands secrete the oily part of tears are also located on the eyelid margin. The eyelid margins are the areas most often affected by blepharitis.

What is seborrheic blepharitis?

Seborrheic blepharitis is associated with dandruff of the scalp and may be part of an overall skin disease (seborrhea) which also affects the chest, back, and behind the ears. With seborrheic blepharitis, the glands of the eyelid produce an abnormal quantity and quality of teat film, which normally coats, protects, and lubricates the eye. Several factors including hormones, nutrition, general physical condition, and stress may contribute to the development of this condition.

Blepharitis cross section
Blepharitis cross section

Blepharitis is a chronic inflammation that affects the eyelids (1) and the eyelash hair follicles (2). Careful eyelid hygiene can do much to control blepharitis.

Symptoms and Treatment

This form of blepharitis is characterized by redness of the eyelids. Scaling and flaking around the eyelashes are also common. The production of abnormal tear film causes the formation of greasy, waxy scales. These scales, which accumulate at the base of the eyelashes, flake off easily.

Staph blepharitis is a more severe condition which often begins in childhood and continues through adulthood. Infective in nature, staph blepharitis continues through adulthood. Infective in nature, staph blepharitis is caused by bacteria (staphylococcus aureus).

Staph blepharitis is characterized by matted, hard crusts around the eyelashes. The crusts may make opening the eyes in the morning difficult. Removal of the crusts often leaves small ulcers which bleed or ooze.Staph blepharitis is characterized by matted, hard crusts around the eyelashes. The crusts may make opening the eyes in the morning difficult. Removal of the crusts often leaves small ulcers which bleed or ooze.

In some cases of staph blepharitis, a red eye may develop or a sty may form. A loss of lashes or broken lashes may be experienced. If left untreated, staph blepharitis may lead to infection and scarring of the cornea and other areas of the eye.

It is often difficult to distinguish between the two types of blepharitis, as they frequently appear together. The main difference is the presence of ulcers with staph blepharitis. These ulcers are not present with seborrheic blepharitis. However, both forms of the disease are treated similarly. Treatment of blepharitis is concentrated on maintaining very clean eyelid margins. The eyelids must be kept immaculately clean.

This should be done every morning as maintenance therapy and two to three times a day if your Blepharitis is active. Think of this like brushing your teeth, if you keep them clean you get fewer cavities. Warm water scrubs are inexpensive, feel great and they work. There are not many treatments so inexpensive and effective. 80% of eye lid infections can be treated this way, the remaining 20% need additional help such as antibiotic drops or ointment. Please consult your eye care provider.

  • Wash your hands thoroughly.
  • Saturate the clean washcloth with warm/hot water and then ring out.
  • Close one eye and using the clean hot wash cloth, rub back and forth across the eyelashes and the edge of the eyelid for at least 60 seconds per eye.
  • Rinse with clear, cool water.

Maintaining very clean eyelid margins is one of the most important aspects of treatment for blepharitis.
In severe cases, antibiotic drops and ointments are also helpful in controlling the condition. Cortisone drops or preparations often relieve the bothersome symptoms of itching and irritation. However, prolonged use of cortisone may cause undesirable effects.

Application of hot packs may provide additional relief. The heat causes the blood vessels to dilate, which improves blood circulation and healing. The heat also opens and cleans out infected gland pores in the eyelid margin. In cases of seborrheic blepharitis, treatment of the scalp with anti-dandruff shampoos may also be helpful.


Once the acute phase of blepharitis is controlled, lid cleaning and the use of bland ointments may be sufficient to control the condition. Blepharitis can be a continuing problem which is difficult to eliminate completely. However, with vigorous treatment and patient cooperation, blepharitis can almost always be controlled.

Prevention is the best medicine

Regular eye examinations are the best prevention against eye diseases. Eye problems can occur at any age, and the symptoms of some problems are not noticeable until the eye has suffered damage. However, with early detection and treatment of eye problems, sight loss can often be prevented.

If you are experiencing the symptoms of blepharitis or other vision problems, you should obtain a complete eye examination from an eye care professional.