BLEPHARITIS

An inflammatory condition of the eyelids

What is Blepharitis?

Blepharitis is a chronic inflammatory condition of the eyelids. It affects people of all ages but is more common in older adults. The eyelids contain Meibomian glands, which produce oils to lubricate the eye. When these glands become blocked or inflamed, symptoms develop.

There are three types of blepharitis:

• Anterior Blepharitis – Affects the front of the eyelid, often related to seborrhoeic dermatitis (like dandruff) or bacterial infection.
• Posterior Blepharitis – Affects the back part of the eyelid (Meibomian glands), often linked to rosacea.
• Mixed Blepharitis – Involves both the front and back of the eyelid.

What Are the Symptoms?

• Red, crusted, or swollen eyelids
• Burning or gritty sensation
• Dry eyes or watery eyes
• Light sensitivity
• Blurred vision
• Fine flakes near the eyelashes (like dandruff)
• Loss or misdirected eyelashes
• Styes or Meibomian cysts
• Small eyelid ulcers in severe cases

Diagnosis

An eye specialist uses a slit-lamp microscope to examine the eyelids and tear film. Fluorescein dye may be used to check for corneal dryness or damage.

Treatment Options

1. Eyelid Hygiene

• Warm Compresses: Use a warm flannel or a heated eye mask (e.g., Optase, MGDRx Eye Bag, EyeSoothe).
• Lid Massage: Gently press along the eyelid margins to express blocked oil glands.
• Cleaning:
  • Use cooled boiled water with cotton buds to clean the eyelid margins
  • Use commercial wipes (e.g., Blephaclean, Ocusoft) if preferred

2. Eye Lubrication

• Preservative-free artificial tears (e.g., Hycosan, Thealoz Duo)
• Night-time lubricating eye ointments

3. Medications

• Antibiotic drops or ointments (e.g., fusidic acid, chloramphenicol)
• Oral antibiotics (e.g., doxycycline, lymecycline) for posterior blepharitis or rosacea — avoid in pregnancy
• Short-term topical steroids for flare-ups (under specialist supervision only)

4. Nutritional Support

• Omega-3 supplements (fish oil or flaxseed)
• Anti-inflammatory diet: Ginger, turmeric, green leafy vegetables
• Probiotics (yogurt, kefir) and high-fibre foods to support gut health

5. Lifestyle Modifications

• 20-20-20 rule for screen use
• Avoid screen time late at night
• Sleep 7–8 hours per night
• Stay well-hydrated
• Reduce alcohol and caffeine intake
• Regular physical activity

6. Additional Self-Care Products

• Manuka honey eye drops (available over the counter) may help soothe the eyelids and reduce inflammation.
• Tea tree oil–based face washes and lid cleansers may reduce demodex mite population (linked to blepharitis).

What Happens Without Treatment?

Blepharitis is chronic and typically does not resolve on its own. Without treatment, it can lead to:

• Recurrent styes and lid cysts
• Conjunctivitis
• Corneal irritation or ulceration
• Vision disturbances

Daily Self-Care Plan

Morning & Evening Routine	Nutrition & Lifestyle
Warm compress (5–10 min)	Omega-3 supplements
Lid massage	High-fibre, anti-inflammatory diet
Lid cleansing with wipes or cotton bud	Stay hydrated, reduce caffeine/alcohol
Lubricant eye drops	Regular sleep, 20-20-20 rule