Blepharitis

This long-lasting eyelid condition can be difficult to treat. It might be uncomfortable, but it doesn't usually damage eyesight.

Update Date: 20.09.2025

Overview
Symptoms
When to see a doctor
Causes
Risk factors
Complications
Diagnosis
Treatment
Self care
Alternative medicine
Preparing for your appointment

Overview

Blepharitis (blef-uh-RYE-tis) is a condition that causes swelling, itching and other irritation of the eyelids. Blepharitis usually affects both eyes along the edges of the eyelids.

Blepharitis may be caused by usually harmless bacteria on eyelids that become overpopulated. Another common cause is clogged oil glands of the eyelid. Other diseases or conditions may play a role in blepharitis or make it more likely to occur.

Blepharitis can't be cured, but daily care and treatments can usually control the symptoms. Blepharitis can be uncomfortable, but it usually doesn't cause permanent damage to your eyesight. It can't be passed from one person to another.

Blepharitis

Blepharitis causes the eyelids to become swollen, itchy and irritated. The eyelid may look greasy or become crusted with scales that cling to the lashes. People with blepharitis sometimes wake with their eyelids stuck together. Others may wake with dried tears around their eyes and a feeling of sand in their eyes. In this photo, the yellow around the eye is from a yellow dye sometimes used in diagnostic tests.

Symptoms

Blepharitis symptoms are typically worse in the morning. They may include:

  • Swollen eyelids.
  • Changes in the color of the eyelids.
  • Itching or other irritation of the eyelids.
  • Flaking of the skin around the eyes.
  • Eyelids that appear greasy.
  • Crusted eyelashes.
  • Eyelids sticking together.
  • Tears that appear foamy.
  • Watery eyes.
  • Red eyes.
  • A gritty, burning or stinging sensation in the eyes.
  • More frequent blinking.
  • Sensitivity to light.
  • Blurred vision that usually improves with blinking.

When to see a doctor

If you have blepharitis symptoms that don't improve with regular bathing or washing, make an appointment with your healthcare professional.

Causes

Blepharitis is inflammation of the eyelids. Inflammation is the immune system's response to something it sees as a foreign substance in the body. This activity can cause swelling, irritation and other changes in the tissues of the eyelid.

Often blepharitis is caused by one of two factors. It is typical for certain bacteria to live on the surface of the eyelids and eyelashes. If this group of bacteria grows unusually, it may cause inflammation.

Pores near the base of the eyelashes release oils. Clogged oil pores may be another likely cause of blepharitis.

But the cause of blepharitis might not be known.

Risk factors

Several conditions seem to play a role or increase the risk of getting blepharitis, including:

  • Dandruff of the scalp and eyebrows, also called seborrheic dermatitis.
  • Bacterial disease of the eyes or eyelids.
  • An inflammatory skin condition called rosacea that changes the color or appearance of skin.
  • Allergies, including allergic reactions to eye medicines, contact lens solutions or eye makeup.
  • An excess of eyelash mites, which are common but usually harmless.
  • Tiny insects, called lice, that live on the scalp or other skin.
  • Dry eyes.

Complications

Blepharitis may lead to other problems near the eyes, including:

  • Eyelash problems. Blepharitis can cause your eyelashes to fall out, lose color or grow toward your eyes rather than away from them.
  • Eyelid skin problems. Scarring can develop on your eyelids from long-term blepharitis. Or the eyelid edges might turn inward or outward.
  • Excess tearing or dry eyes. The tear film is the substance covering the eyes and keeps the eyelids moist. Excess oil, flakes of skin or other debris can create an irregular tear film that irritates the eye, causing dryness or excess tearing.
  • Stye. A stye is a painful bump on the edge of the eyelid or inside the eyelid. It's usually caused by a bacterial infection at the base of an eyelash or in an oil gland.
  • Chalazion. A chalazion is a swollen bump on an eyelid caused by a blocked oil gland that causes inflammation. It usually doesn't cause pain, but it may become tender as it gets larger.
  • Chronic pink eye. Blepharitis can lead to frequent cases of pink eye. Pink eye, also called conjunctivitis, is inflammation of the film over the white of the eye.
  • Injury to the cornea. Constant irritation from inflamed eyelids or misdirected eyelashes can cause a sore to develop on your cornea. Not having enough tears could increase your risk of other diseases of the cornea.

Stye

A stye is a bacterial infection involving one or more of the small glands near the base of your eyelashes. It is similar to a boil or a pimple and is often painful.

Chalazion

A chalazion is a bump on the eyelid. A chalazion occurs when a blocked oil gland becomes inflamed and swollen. Although a chalazion usually doesn't cause pain, it may become tender as it becomes more swollen. This photo shows a large chalazion on the upper eyelid and a smaller one on the lower eyelid.

Diagnosis

A diagnosis of blepharitis is generally based on a careful examination of the eyelid and eyes. Tests and procedures used to diagnose blepharitis may include:

  • Examining your eyes. Your healthcare professional might use a special magnifying instrument to examine your eyelids and your eyes.
  • Laboratory tests. In certain cases, your eye might be swabbed to collect a sample of the oil or crust on the eyelid for tests of bacteria. Examination of eyelashes under a microscope can show excess eyelash mites.

Response to treatments generally confirm the diagnosis of blepharitis. If there is no improvement with treatment, particularly in one eye, your healthcare professional may order additional testing to see if the symptoms are caused by an eyelid skin cancer or an immune-system disorder. Other signs of these disorders may include loss of eyelashes or scarring on the film covering the eye, also called the conjunctiva.

Treatment

Self-care measures, such as washing your eyes and using warm compresses, might be all that's needed for most cases of blepharitis. If self-care measures aren't enough, your healthcare professional might suggest prescription treatments, including:

  • Medicines that fight infection. Antibiotics have been shown to provide relief of symptoms that may be related to bacteria colonies on the eyelids. These medicines are available in several forms, including eye drops, creams and ointments. If these medicines don't improve symptoms, you may take an antibiotic pill.
  • Medicines to control inflammation. Steroid eyedrops or ointments to treat inflammation are generally used for people who don't respond to other therapies. You may have a prescription for both antibiotic and anti-inflammatory drugs.
  • Medicines that affect the immune system. Cyclosporine eyedrops (Restasis, Cequa, others) have been shown to offer relief of some signs and symptoms of blepharitis.
  • Treatments for underlying conditions. Blepharitis possibly related to dandruff, rosacea or other conditions might be controlled by treating the underlying disease.

Blepharitis rarely disappears completely. Even with successful treatment, the condition frequently is chronic and requires daily attention with eyelid cleaning.

Self care

Self-care measures are the only treatment needed for most cases of blepharitis.

Clean your eyes daily

If you have blepharitis, you'll need to follow a daily self-care routine. You will do the routine 2 to 4 times a day, but the number of times may vary depending on your symptoms. The following steps should be done with separate washcloths or swabs for each eye:

  • Apply a washcloth warmed with water over your closed eye for several minutes to loosen the crusty deposits on your eyelids. Reheat the cloth with warm water as needed.
  • Firmly but gently massage the eyelids, using a new clean washcloth or a clean finger.
  • Immediately use a clean washcloth or cotton-tipped applicator moistened with warm water and a few drops of diluted baby shampoo or a nonprescription eyelid cleanser to wash away oily debris or scales at the base of your eyelashes. You may need to gently pull the eyelid away from the eye to avoid contact with the eye.
  • Rinse your eyelids with warm water and gently pat them dry with a clean, dry towel.
  • If you have a prescription ointment, cream or eye drop, use it as directed after cleaning your eyes.

Lubricate your eyes

Try nonprescription artificial tears. These eyedrops can help relieve dry eyes.

Control dandruff and mites

If you have dandruff that may be contributing to your blepharitis, ask your healthcare professional to recommend a dandruff shampoo. Using a dandruff shampoo might relieve your blepharitis signs and symptoms.

If your healthcare professional believes an excess of eyelash mites is causing blepharitis, you may be asked to use a tea tree oil shampoo or 50% tea tree oil scrub. You can purchase these without a prescription.

Contact your healthcare professional if you don't see improvement in six weeks. And stop using tea tree oil if it irritates your skin or eyes.

Avoid eye makeup

It might help to stop using eye makeup when you have symptoms of blepharitis. Makeup can make it harder to keep your eyelids clean and free of debris. Also, it's possible that makeup could reintroduce bacteria to the area or cause an allergic reaction.

Alternative medicine

No alternative medicines have been proved to ease the symptoms of blepharitis. However, a diet rich in omega-3 fatty acids or supplements containing omega-3 fatty acids might help blepharitis linked with rosacea. Omega-3 fatty acids are found in foods such as salmon, tuna, trout, flaxseed and walnuts. More study is needed.

Preparing for your appointment

You're likely to start by seeing your primary healthcare professional. You may be referred to an eye specialist, such as an optometrist or ophthalmologist.

Here's some information to help you get ready for your appointment.

What you can do

Make a list of the following:

  • Your symptoms, including any that may seem unrelated to problems with your eyelids or eyes, and when they began.
  • All medicines, vitamins or other supplements you take, including doses and the reasons for taking them.
  • Questions to ask your healthcare professional.

For symptoms related to your eyelids, questions may include:

  • What is likely causing my symptoms?
  • What are other possible causes for these symptoms?
  • What medical conditions can cause this problem?
  • What tests will I need?
  • Should I see a specialist?
  • Are there brochures or other printed material I can have? What websites do you recommend?
  • Can I continue to wear contact lenses?
  • Do I need to take special care cleaning my contact lenses and my contact lens case?
  • Can I continue to wear eye makeup?
  • Will I need a follow-up visit? If so, when?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, such as:

  • Do your symptoms come and go, or do you always have them?
  • Are your symptoms worse in the morning or later in the day?
  • Have you been wearing contact lenses?
  • Have you changed cosmetic brands recently?
  • Have you changed soap or shampoo brands recently?
  • Does anything seem to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Has anyone close to you had a recent eye infection?
  • Have you ever had any eye diseases, eye surgeries or eye injuries?
  • Do you have other diseases or conditions?

What you can do in the meantime

Follow the self-care steps 2 to 4 times a day to clean your eyelids. Avoid anything that irritates your eyes, such as eye makeup and contact lenses.

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