What Causes Blepharitis and How to Treat It

Blepharitis is the medical term used to describe inflammation of the eyelids, a problem that is very common. This inflammation causes red eyelids and crusty eyelashes that can become very painful for the individual. Luckily, it’s easy to treat and, providing it is caught early, it won’t cause any severe damage to your eyes. But what causes it and how can you manage the symptoms?

Causes of Blepharitis

There are several reasons why you might be suffering from blepharitis, including:

  • Bacterial infection
  • Dry eyes
  • Fungal infection
  • Meibomian gland dysfunction or MGD
  • Parasites, also known as Demodex eyelash mites

It is common for dry eyes to occur at the same time as blepharitis, making it difficult to know which the root cause is. In fact, it happens so regularly that researchers believe that they may both part of a single eye problem known as dry eye blepharitis syndrome (DEBS).

Blepharitis is typically associated with a build-up of bacteria that lives on the rim of the eyelid and at the root of the eyelashes. These bacteria can multiply over time and create a structure known as a biofilm which feeds eyelash mites called Demodex. The parasitic mites develop as the film gets more severe, causing the inflammation of the eyelids to get even worse. People who suffer from skin conditions like eczema and psoriasis are more likely to develop blepharitis, and this condition can often occur at the same time as pink eye or conjunctivitis as well.

What are the Symptoms of Blepharitis?

You may be suffering from blepharitis is you’re struggling with any of the following symptoms:

  • Burning or stinging sensation in the eyes
  • Watery eyes
  • The crusty build-up at the base of the eyelashes
  • A gritty feeling in the eyes
  • Itching

Depending on how severe your condition is, you might find you have several or all of these symptoms which may be constant or come and go. In really severe cases, blepharitis can even be the cause of a loss of eyelashes, also known as madarosis.

How is Blepharitis Treated?

If you suspect you might have blepharitis, it’s important to book in to see your optician as soon as possible to diagnose you. There are several forms of treatment depending on the severity of your blepharitis, which include:

Eyelid scrubs – These help to remove the build-up of bacteria and debris in the eyelashes. Your eye doctor will usually suggest a regimen of warm compresses on the eyes and lid scrubs to be used daily, which will help reduce the amount of biofilm and Demodex mites on your eyes.

Medicated eye drops or ointment – Topical medication is sometimes prescribed to patients to help kill the bacteria and microbes on the eyelids. If you have a pink eye at the same time as blepharitis, this is the most common treatment as it will tackle both infections.

In-office treatments – Home treatments like eyelid scrubs are helpful, but to really treat blepharitis properly, in-office hygiene is vital. These may include electromechanical lid margin debridement such as BlephEx; thermal pulsation treatment such as Lipiflow to melt the material on the Meibomian glands; or intense pulsed light therapy which helps to open the eyelid glands that have become clogged and help oils to flow into the tear film which will help your eyes naturally clean themselves.

Tips for Keeping Your Eyes Clean

Maintaining proper eyelid hygiene is also crucial for not only treating blepharitis but preventing it from developing again. Use a clean compress with warm water to melt away any blocked residue in the Meibomian glands in your eyelids and gently rub the eyelid with a washcloth before opening your eyes. Make sure the water isn’t too hot and also don’t rub your eyelids too hard, as this can cause tears in the delicate skin.

Another way of keeping your eyelids clean is to use a cleaning agent such as diluted baby shampoo, warm water or an over-the-counter prescription eyelid cleanser. Your optician can recommend the best option for your condition so as not to aggravate your symptoms. To clean your eyelids thoroughly, first wash your hands and then moisten a clean cloth or cotton swab with the recommended solution. Gently wipe it over your eyelids and the eyelid margin before rinsing your eyes thoroughly with warm water. When you repeat this process on your other eye, remember to use a new cloth or cotton swab so as not to transfer any bacteria. Your optician will probably suggest cleaning your eyelids in this way several times a day initially until the symptoms start to subside, at which point you can clean them just once a day.

Another tip for making your treatment more effective is to avoid using eye make-up as this can interfere with eyelid hygiene and can lead to more microbes being transferred to the eye. If you wear daily lenses, torics or monthlies, your optician will likely suggest that you stop wearing them until your eyes have been completely treated as they can also lead to more bacteria getting stuck to your eye. Once blepharitis has gone, you can resume wearing lenses but make sure that you thoroughly clean your hands before putting them in to prevent blepharitis flaring up again.

How to Prevent Blepharitis from Developing

Blepharitis is a chronic condition so those who suffer from it often find it returns regularly. The easiest and simplest way of preventing blepharitis from developing is to clean your eyelids each day to stop the bacteria from building up and to prevent Demodex mites from breeding on the eyelid margin. You may find that an over-the-counter lid scrub is beneficial in maintaining good eye health, which you can use on a semi-regular basis to keep your eyelids free from debris and microbes. Your doctor might also suggest an omega-3 fatty acid supplement that will ensure your Meibomian glands stay healthy and lubricated. This will prevent dry eyes from forming. Omega-3 fatty acids can either be added into your diet in supplement form or through ingredients like oily fish, flaxseeds and walnuts.