Friday 24 November 2017

Daily eyelid hygiene the key when dealing with blepharitis

By Dr Michelle Cooper

Blepharitis means inflammation of the eyelids. It causes the eyes to feel sore and gritty. It can be a troublesome and recurring condition with no one-off cure. However, once symptoms have improved, daily eyelid hygiene can usually keep symptoms to a minimum.

It usually affects the edges (margins) of the eyelids and is not usually serious, but may become an uncomfortable, irritating problem. Blepharitis is typically persistent (chronic). Both eyes are usually affected.


There are three main types of blepharitis: staphylococcal blepharitis, seborrhoeic blepharitis and meibomian blepharitis. All three types can cause similar symptoms.

Staphylococcal blepharitis is thought to be caused by a germ (bacterium) called staphylococcus. This bacterium commonly lives in low numbers on the skin without doing any harm. However, in some people, it seems that this bacterium causes an infection of the eyelids, resulting in blepharitis. Exactly why or how this happens in some people is unclear.

Seborrhoeic blepharitis is closely associated with a skin condition called seborrhoeic dermatitis. In seborrhoeic dermatitis, the affected skin becomes oilier and can become scaly. Seborrhoeic dermatitis typically causes bad dandruff and sometimes a rash, commonly on the face and upper body.

Meibomian blepharitis is also known as meibomian gland dysfunction. The tiny meibomian glands in the eyelids lie just behind the eyelashes. They make a small amount of oily fluid which comes out on the inside of the eyelids next to the eye. People with meibomian blepharitis are thought to have a slight problem with their meibomian glands and the fluid they produce. This may lead to eyelid inflammation.


- The main symptom is sore eyelids. Both eyes are usually affected.

- The eyes may feel gritty, itchy or as though they are burning.

- The eyelids may look inflamed or greasy.

- The eyes may become sticky with discharge. In particular, the eyelids may stick together in the morning.

- Sometimes tiny flakes or scales appear on the eyelids, which look like small flakes of dandruff. Crusts may develop at the base of eyelashes.

- One or more of the tiny glands of the eyelids (meibomian glands) may block and fill with an oily fluid.

Symptoms often come and go. Typically, symptoms flare up from time to time, but you may have long periods without any symptoms.


There is no one-off cure for blepharitis, as the inflammation tends to recur if you do not keep up with treatment. The aim of treatment is to control or manage blepharitis, not to cure it.

Regular eyelid hygiene is the most important part of treatment and prevention of blepharitis. The aim is to soothe the eyelids, unplug any blocked meibomian glands and clear out any stagnant oily secretions from these glands. The eyelids are cleaned and debris is removed. This is a daily routine that consists of three parts - warmth, massage and cleansing.

The purpose of warmth is to soften the skin and any crusts attached to the eyelids. It also allows the oily secretions made by the meibomian glands to flow more freely, as warmth makes oils more runny.

Massage the eyelids immediately after applying the warmth. Massaging helps to push out the oily fluid from the tiny meibomian glands. To massage the eyelids massage along the length of the upper and lower eyelids towards the eye. Repeat this massage action 5 to 10 times over about 30 seconds immediately following the warming. Always massage with your eyes shut.

After warmth and massage, clean the eyelids. The traditional way is to use a cotton wool bud that has been dipped in diluted baby shampoo. Just add a few drops of baby shampoo to a small cup of warm water so that the ratio of water to shampoo is about 10:1. After cleaning the eyelids with the cotton wool bud, wash off the shampoo from the eyelids, using a flannel or cloth.

Further advice

- Wearing eye make-up, particularly eyeliner, may make symptoms worse. It is best to avoid eyeliner, particularly during a flare-up.

- Rubbing your eyelids may make inflammation worse, so try to avoid doing this.

- Studies suggest that omega 3, found in fish oils, may improve symptoms for people with dry eye syndrome and blepharitis. It is not yet known how much should be used, but it may help to take omega-3 supplements, available in health food shops and pharmacies.

Wexford People

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