Blepharitis (blef-uh-RI-tis) affects the skin of the eyelids, and it usually involves the part of the eyelid where the eyelashes grow (lid margins). Commonly, blepharitis occurs when tiny oil glands located near the base of the eyelashes malfunction. When these oil glands malfunction, bacterial overgrowth can result, leading to inflamed, irritated and itchy eyelids. Blepharitis is often a chronic condition that is difficult to treat. Although it's uncomfortable and may be unattractive, blepharitis doesn't cause permanent damage to eyesight.

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Blepharitis

Signs and symptoms of blepharitis include:

• Watery or red eyes
• A gritty, burning sensation in the eye
• Itchy eyelids
• Red, swollen eyelids
• Flaking of the skin around the eyes
• Crusted eyelashes upon awakening
• Sensitivity to light
• Frothy tears
• Eyelashes that grow abnormally (misdirected eyelashes)
• Loss of eyelashes

The eyelids may appear greasy and crusted with scales that cling to the lashes. This debris can cause the eyelids to stick together at night. You may have to pry your eyes open in the morning because of these sticky secretions. Sometimes you may notice only the presence of dried tear secretions in the morning that feel like small grains of sand.

Blepharitis is often a chronic condition that can affect the outer portion of your eyelid where the eyelashes attach (anterior blepharitis) or the inner portion of your eyelid that comes into contact with your eye (posterior blepharitis).

Conditions associated with blepharitis include:

• Seborrheic dermatitis — dandruff of the scalp and eyebrows
• A bacterial infection
• Malfunctioning oil glands in your eyelid
• Rosacea — a skin condition characterized by facial redness

Blepharitis may be caused by a combination of factors. Less commonly, blepharitis may result from allergies or even an infestation of lice on the eyelashes.

If your signs and symptoms don't seem to be improving despite good hygiene — regular cleaning and care of the area — make an appointment to see your doctor.

Your doctor will be able to diagnose blepharitis after carefully examining your eyes and eyelids. He or she may use a special magnifying instrument during the examination. Sometimes, a sample of the skin deposits may be collected to see if any bacteria are present.

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Sty

If you have blepharitis, you may experience loss of eyelashes, abnormal eyelash growth (misdirected eyelashes) or scarring of the eyelids. Other possible complications associated with blepharitis include:

• Sty. A sty is a bacterial infection that develops near the root of an eyelash. The result is a painful lump on the edge or inside of your eyelid. A sty is usually most visible on the surface of the eyelid.
• Chalazion. A chalazion occurs when there's a blockage in one of the small oil glands at the margin of the eyelid. The gland can become infected with bacteria, which causes a red, swollen eyelid. Unlike a sty, a chalazion is most prominent on the inside of the eyelid.
• Excess tearing or dry eyes. Abnormal oily secretions and other debris shed from the eyelid, such as flaking associated with dandruff, can accumulate in your tear film — the water, oil and mucus solution that form tears. Abnormal tear film interferes with the healthy lubrication of your eyelids. There may be enough irritation to stimulate excessive tearing. Inflammation associated with blepharitis can interfere with the function of some of the non-oil-producing glands in the eyelid and lead to dry eyes.
• Chronic pink eye. Blepharitis can lead to recurrent bouts of pink eye (conjunctivitis).
• Injury to the cornea. Constant irritation from inflamed eyelids or misdirected eyelashes may cause a sore (ulcer) to develop on your cornea. Insufficient tearing could predispose you to a corneal infection.

Blepharitis can be difficult to treat. Good hygiene — regular cleaning of the area — can control signs and symptoms and prevent complications.

But if your condition doesn't improve, your doctor may prescribe an antibiotic cream or ointment. In severe cases, eyedrops containing antibiotics and steroids may be prescribed. If your blepharitis is linked to an underlying cause such as dandruff or rosacea, treating those conditions may alleviate the blepharitis.

Blepharitis rarely disappears completely. Even with successful treatment, relapses are common. Paying extra attention to good hygiene at those times may help bring the condition back under control.

If you have blepharitis, follow this self-care remedy once or twice a day:

• Apply a warm compress over your closed eye for 10 minutes.
• Immediately afterward, use a washcloth moistened with warm water and a few drops of baby shampoo to wash away any oily debris or scales at the base of your eyelashes.
• Rinse your eyelid with warm water and gently pat it dry with a clean, dry towel.

You may need to deliberately clean your eyelid at the base of the eyelashes. To best accomplish this, gently pull the eyelid away from your eye to avoid accidental injury to the cornea from the washcloth. Ask your doctor if it's wise to also use a topical antibacterial solution after cleaning your eyelid in this manner.

Continue this treatment until your signs and symptoms disappear. Although you may be able to decrease the frequency of eyelid soaking and washing, you should maintain an eyelid care routine to keep the condition under control. If you experience a flare-up, resume once or twice daily self-care treatment.

If you have dandruff, using a dandruff shampoo may help alleviate your symptoms.