Blepharitis: What It Is & How to Manage It

What Is Blepharitis?

Blepharitis is a common inflammation of the eyelids affecting the edge of the eyelids, called the lid margins.  

The most common underlying causes are bacteria and microscopic Demodex mites, both of which live naturally on the skin but can overgrow and trigger inflammation along the eyelid margins.

Meibomian glands are oil glands in the eyelids that contribute to a healthy tear film. Meibomian Gland Dysfunction (MGD) is when bacteria and/or Demodex mites cause the oil glands to get clogged or their secretions to change, causing the tear film to be less effective in moisturizing and protecting the eye.

What Are Common Symptoms?

• Grittiness, burning, or a foreign-body sensation
• Tearing or dryness
• Red or swollen eyelids; crusts or flakes along the lashes
• Blurry vision that improves with blinking
• Sensitivity to light

Key Management & Treatment Steps

Eyelid Cleaning

The American Academy of Ophthalmology recommends lid cleaning once a day as a first-line measure, preferably in the evenings. Blepharitis is often chronic, with periods of flare-ups and improvement, so routine maintenance is key.

• Apply warm compresses for 5–10 minutes to soften oils and loosen debris.
• Follow with gentle wiping of the eyelid margins using a lid-cleaning solution to remove oils and crusts.

Choosing the Right Lid Cleanser

Because blepharitis can be caused by bacteria, Demodex mites, or both, the cleaning solution should match the cause.

• The cleansers for Demodex blepharitis specifically state Demodex mites or tea tree oil (a frequent ingredient) on the label.
• If not otherwise specified, many commercially available eyelid cleansers are for bacterial blepharitis.
• Diluted baby shampoo is also an effective cleanser for bacterial blepharitis. and is a more economical option.

Additional Treatments

Dr. Bart may prescribe:

• Topical antibiotics or antibiotic-steroid combinations
• Oral antibiotics in more severe or chronic cases

There are also in-office treatments, for example, intense-pulsed light (IPL) and thermal lid-expression devices, such as LipiFlow, TearCare, iLux, Mibo Thermoflo, EyeXPress.

Takeaway

If your eyes feel irritated or your eyelids are red or crusty, schedule an eye exam to check for blepharitis. With proper treatment, you can improve comfort and maintain long-term eye health.