Eye health resource
What Are the Causes of Blepharitis?
Blepharitis is chronic eyelid inflammation linked to bacteria, clogged oil glands, skin conditions, and sometimes Demodex mites. Learn about symptoms and management.
Reviewed for accuracy by Justin Bazan, OD on .
Blepharitis is inflammation along the eyelid margins. It is commonly associated with excess bacteria around the lashes, clogged or dysfunctional eyelid oil glands, dandruff/seborrheic dermatitis, rosacea, and in some patients Demodex mites.
Blepharitis is usually manageable rather than a problem that is permanently “cured” once and never returns. Good eyelid care and treatment of the underlying cause can reduce symptoms and flare-ups.
What Does Blepharitis Feel Like?
Common symptoms include:
- burning or stinging
- itchy or irritated eyelids
- red or swollen lid margins
- crust or flakes around the eyelashes
- a gritty or foreign-body sensation
- watery or dry eyes
- light sensitivity
- intermittent blur that improves with blinking
More severe inflammation can contribute to styes, chalazia, misdirected lashes, or irritation of the cornea.
Anterior vs. Posterior Blepharitis
Anterior Blepharitis
Anterior blepharitis affects the outer lid margin where the eyelashes emerge. It may be associated with bacterial overgrowth, seborrheic dermatitis, or Demodex mites.
Posterior Blepharitis
Posterior blepharitis involves the meibomian glands along the inner lid margin. These glands normally release oil that helps slow tear evaporation. When the glands are obstructed or their oil is abnormal, the eyelid margin can become inflamed and dry-eye symptoms may worsen.
Rosacea is a common associated condition.
What Is Demodex Blepharitis?
Demodex mites normally live in human hair follicles and skin. When the mite population around the eyelashes becomes excessive, it can contribute to eyelid inflammation.
Characteristic waxy cylindrical debris at the base of the eyelashes—often called collarettes—is strongly associated with Demodex blepharitis. Treatment should be based on the actual examination rather than assuming every flaky eyelid is caused by mites.
How Is Blepharitis Treated?
The treatment plan depends on the pattern and cause. Common approaches can include:
- regular eyelid hygiene
- warm compresses when appropriate
- lid cleansers
- artificial tears when dry eye is also present
- prescription antibiotic or anti-inflammatory treatment in selected cases
- treatment of associated rosacea, dandruff, allergy, or other skin disease
- targeted Demodex treatment when Demodex is actually present
Park Slope Eye currently uses lid-hygiene cleansers, lubricating drops, prescription eye drops when indicated, and other nonprocedural dry-eye/eyelid management within the practice's scope. We do not currently advertise or provide in-office procedural dry-eye treatments such as meibomian-gland expression.
Can Blepharitis Cause Dry Eye?
Yes. Inflammation and meibomian-gland dysfunction can destabilize the tear film, which may cause burning, grittiness, watery eyes, and fluctuating blur.
That overlap is one reason persistent “dry eye” symptoms sometimes need an eyelid examination rather than simply trying another bottle of artificial tears.
Is Blepharitis Contagious?
Blepharitis itself is generally not considered contagious. Good hand and eyelid hygiene is still important, particularly when there is crusting or another eye infection is also possible.
When Should I Get Checked?
Arrange an examination if eyelid redness, crusting, irritation, or recurrent styes do not improve with simple lid hygiene, or if the symptoms keep returning.
Significant eye pain, marked light sensitivity, corneal-looking spots, a sudden decrease in vision, or a very red painful eye—especially in a contact-lens wearer—needs more prompt evaluation.
Park Slope Eye can evaluate blepharitis as part of dry-eye care or medical eye care. Book an appointment if eyelid symptoms are persistent or recurrent.
Originally published . Substantially updated .