A chronic inflammatory condition of the eyelids, common in children and adults, which causes redness, burning, itching, swollen and/or crusty lid margins and dry-eye symptoms. Maintaining very clean eyelid margins is one of the easiest treatments. In more severe cases, antibiotic drops and ointments are used to control the condition.

Blepharitis is a common condition that involves an inflammation of the eyelids (blepharo-lid, itis-inflammation). The causes of blepharitis are usually noninfectious. In unusual cases it may be due to bacterial, viral, chlamydial or fungal organisms. Most commonly it is due to inflammation associated with skin problems or systemic disorders.

The lids contain skin, eyelashes (cilia), and meibomian glands. At the base of the lashes (lash follicles) are special glands, which, along with the meibomian glands, secrete an oil or lipid material that, floats on the tear film and prevents evaporation of the tears. Blepharitis involving these glands can affect the oily layer of the tear film leading to increased evaporation and dry eye symptoms.

The common symptoms of blepharitis are mattering or mucus discharge from the eye upon awakening from sleep, redness and irritation of the lid margins, foreign body sensation and stinging, itching of the lids, blurred or decreased vision, and pain or discomfort with bright lights (photophobia). There may also be crusting of the lid margins and, in cases of prolonged blepharitis, there may be sty or chalazion formation. Symptoms tend to be worse upon arising, improving over the next 4-5 hours and then worsening later in the day.

Other factors that are important in the cause of blepharitis include scalp and facial skin diseases such as seborrhea, rosacea, psoriasis or other eczema-like skin diseases.

Evaluation
Careful evaluation of the eyelids and the eye by the eye doctor is used to determine what is causing the symptoms that you may have. At times, samples are taken from the surface lining the lids and the secretions from the meibomian glands to determine if there is any infection.

Treatment
The mainstay of treatment for blepharitis is lid hygiene. Oftentimes, there is dry, crusted material along the lid along with plugged meibomian glands. The application of heat helps to dissolve these secretions. This is accomplished by applying a warm washcloth to the closed eye for 5 minutes at bedtime and upon awakening.

At bedtime, an ointment may be prescribed for you to apply in the eyes and to the lids. Before using the ointment, gently warm the closed tube under warm water or in your hand. This will make the ointment easier to apply. Ointment may be gently placed in the eye by gently pulling the lower lid down and depositing small amounts of the ointment on the inside of the lid. Alternatively, ointment may be placed on a cotton-tipped applicator or a finger and applied to the lids.

Artificial tears, antibiotic and or cortisone drops may be used if there is significant infection or inflammation. These drops should be used only as directed by the eye doctor.