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Blepharitis

Inflammation of the eyelids near the eyelashes.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Blepharitis

Blepharitis occurs in two forms:

Anterior blepharitis affects the outside front of the eyelid, where the eyelashes are attached. The two most common causes of anterior blepharitis are bacteria (Staphylococcus) and scalp dandruff.

Posterior blepharitis affects the inner eyelid (the moist part that makes contact with the eye) and is caused by problems with the oil (meibomian) glands in this part of the eyelid. Two skin disorders can cause this form of blepharitis: acne rosacea, which leads to red and inflamed skin, and scalp dandruff (seborrheic dermatitis).

What other conditions are associated with blepharitis?

Complications from blepharitis include:

Stye: A red tender bump on the eyelid that is caused by an acute infection of the oil glands of the eyelid.

Chalazion: This condition can follow the development of a stye. It is a usually painless firm lump caused by inflammation of the oil glands of the eyelid. Chalazion can be painful and red if there is also an infection.

Problems with the tear film: Abnormal or decreased oil secretions that are part of the tear film can result in excess tearing or dry eye. Because tears are necessary to keep the cornea healthy, tear film problems can make people more at risk for corneal infections... More about Blepharitis NIH - National Eye Institute

What works? Research summarized

Evidence reviews

Interventions for blepharitis

Blepharitis, defined as inflammation of the eyelids, is a common eye condition and affects both children and adults. Blepharitis can be categorized in several different ways. First, categorization is based on the length of disease process: acute or chronic blepharitis. Second, categorization is based on the anatomical location of disease: anterior, or front of the eye (e.g. staphylococcal and seborrheic blepharitis), and posterior, or back of the eye (e.g. meibomian gland dysfunction (MGD)). This review focuses on chronic blepharitis and stratifies anterior and posterior blepharitis. There were 34 studies (2169 participants with blepharitis) included in the review, 20 of which included participants with anterior blepharitis and 14 of which included participants with posterior blepharitis. For anterior blepharitis, topical antibiotics provided some symptomatic relief and were effective in clearing bacteria from the eyelid margins. There was no difference between the types of topical antibiotics used. Topical steroids also provided some symptomatic relief; however, they were ineffective in eliminating bacteria. Lid hygiene, including warm compresses and lid scrubs, showed some symptomatic relief in both anterior and posterior blepharitis. Overall, there was no strong evidence for any of the treatments in terms of curing chronic blepharitis. Further research should be done to evaluate the effectiveness of treatments for blepharitis, with particular attention paid to adequate diagnosis and classification of the disease.

Systemic treatment for blepharokeratoconjunctivitis in children

Blepharokeratoconjunctivitis (BKC) is a condition that involves inflammation of the eyelids and the front of the eye. It occurs in children and adults. Children with BKC have watering, itching, red eyes that are painful in bright light. They may develop loss of vision due to scarring of the cornea, which can be described as the front windscreen of the eye. Various treatments are given for BKC, including antibiotics, anti‐inflammatory agents and dietary supplements. Sometimes these treatments are given as eye drops and ointment while in severe cases they may be given systemically (usually orally). It can also be easier to administer medication to children orally than giving eye drops or ointment.

Glaucoma: Diagnosis and Management of Chronic Open Angle Glaucoma and Ocular Hypertension

This guideline covers adults (18 and older) with a diagnosis of chronic open angle glaucoma or ocular hypertension and those with chronic open angle glaucoma or ocular hypertension associated with pseudoexfoliation or pigment dispersion. In addition, the guideline will cover populations who have a higher prevalence of glaucoma and may have worse clinical outcomes including people with a family history of glaucoma, younger people (<50 years) and people who are of black African or black Caribbean descent. Options for pharmacological, surgical, laser and complimentary or alternative treatments are considered in terms of clinical effectiveness and cost effectiveness.

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Summaries for consumers

Interventions for blepharitis

Blepharitis, defined as inflammation of the eyelids, is a common eye condition and affects both children and adults. Blepharitis can be categorized in several different ways. First, categorization is based on the length of disease process: acute or chronic blepharitis. Second, categorization is based on the anatomical location of disease: anterior, or front of the eye (e.g. staphylococcal and seborrheic blepharitis), and posterior, or back of the eye (e.g. meibomian gland dysfunction (MGD)). This review focuses on chronic blepharitis and stratifies anterior and posterior blepharitis. There were 34 studies (2169 participants with blepharitis) included in the review, 20 of which included participants with anterior blepharitis and 14 of which included participants with posterior blepharitis. For anterior blepharitis, topical antibiotics provided some symptomatic relief and were effective in clearing bacteria from the eyelid margins. There was no difference between the types of topical antibiotics used. Topical steroids also provided some symptomatic relief; however, they were ineffective in eliminating bacteria. Lid hygiene, including warm compresses and lid scrubs, showed some symptomatic relief in both anterior and posterior blepharitis. Overall, there was no strong evidence for any of the treatments in terms of curing chronic blepharitis. Further research should be done to evaluate the effectiveness of treatments for blepharitis, with particular attention paid to adequate diagnosis and classification of the disease.

Systemic treatment for blepharokeratoconjunctivitis in children

Blepharokeratoconjunctivitis (BKC) is a condition that involves inflammation of the eyelids and the front of the eye. It occurs in children and adults. Children with BKC have watering, itching, red eyes that are painful in bright light. They may develop loss of vision due to scarring of the cornea, which can be described as the front windscreen of the eye. Various treatments are given for BKC, including antibiotics, anti‐inflammatory agents and dietary supplements. Sometimes these treatments are given as eye drops and ointment while in severe cases they may be given systemically (usually orally). It can also be easier to administer medication to children orally than giving eye drops or ointment.

Terms to know

Chalazion
An eyelid cyst caused by the blockage of a meibomian gland.
Hordeolum (Stye)
An infection of one or more of the glands surrounding the eye.
Inflammation
Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.
Meibomian Glands
A sebaceous gland in the eyelid that produces a specific type of sebum.
Seborrheic Dermatitis
Yellowish, oily, scaly patches of skin on the scalp, face, and occasionally other parts of the body.
Sebum (Oil)
An oily substance produced by certain glands in the skin.

More about Blepharitis

Photo of a young adult

Also called: Eyelid inflammation, Inflammation of eyelid, Inflammation of lid margin

Other terms to know: See all 6
Chalazion, Hordeolum (Stye), Inflammation

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