Definition

Blepharitis is inflammation of the eyelid. It is a very common eye disease that affects the edge of the eyelids and eyelash hair follicles.

There are 3 main types of blepharitis:

• Seborrheic blepharitis—Skin cells shed more rapidly than normal due to a sebaceous gland that is not functioning properly. The sebaceous gland secretes oil to the skin. The presence of excess oil and skin cells help bacteria grow.
• Infectious blepharitis—Bacteria, in particular, staphylococcus, cause an infection in the glands along the eyelid.
• Contact dermatitis blepharitis—Something coming in contact with the eyelid leads to local inflammation. For example, mascara may produce such an allergic reaction.

Causes

The primary types of blepharitis are caused by either a skin condition or a bacterial infection. Blepharitis often occurs along with seborrheic dermatitis and acne rosacea.

Risk Factors

Factors that may increase your chance of blepharitis include:

• Seborrheic dermatitis
• Acne rosacea
• Contact allergies
• Diabetes
• Chemical irritants
• Poor hygiene
• Cosmetic makeup
• Advanced age

Symptoms

Symptoms depend on the cause of the blepharitis. They are usually worse in the morning and involve both eyes.

Blepharitis may cause:

• Redness, flaky skin, and oily secretions along the edge of the eyelid
• Crusty material clinging to the eyelashes
• Eyelids “glued together” in the morning
• Dry scales or dandruff-type material on the scalp and eyebrows
• Itching or burning sensation
• Tearing
• Light sensitivity
• Sensation of a foreign object in the eye
• Ulcers or sores at the base of the eyelashes (in severe cases)
• Scant, broken eyelashes
• Nonpainful bumps in the eyelid— chalazion, which may become infected (stye)
• Irritation or infection of issue that covers the eye and lines the inner surface of the eyelid— conjunctivitis (pink eye)

Diagnosis

Your eye doctor will ask about your symptoms and medical history. An examination of your eyes will be done. Initially you may not have any special tests. If the inflammation looks unusual for blepharitis or fails to respond to treatment, the doctor may do a culture by passing a swab across the edge of the lid. Your doctor may also decide to perform a biopsy by removing a tiny piece of the eyelid margin for microscopic examination to be certain that there is no sign of cancer. Rarely, some cancers can mimic chronic blepharitis.

Treatment

Blepharitis is a chronic condition that often requires long-term management. Treatment depends on the cause of the condition. Your doctor may advise you not to wear contact lenses until the blepharitis has resolved.

Prevention

To help reduce your chance of blepharitis:

• Always wash your hands before touching your eyelids
• Do not share eye makeup
• Wash your hair and face daily

National Eye Institute (NEI) http://www.nei.nih.gov/

The Canadian National Institute for the Blind http://www.cnib.ca

Carter SR. Eyelid disorders: Diagnosis and management. Am Fam Physician 1998;57(11):2695-2702.

Cecil RL, Goldman L, Bennett J. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000.

Dambro MR. Griffith’s 5-Minute Clinical Consult. 2001 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2001.

Goroll AH, Mulley AG. Goroll: Primary Care Medicine. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2000.

Mandell GL, Douglas RG, Bennett JE, Dolin R. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, PA:Churchill Livingstone, Inc.; 2000.