Blepharitis (Granulated Eyelids)

Blepharitis is a condition which causes the eyelids to become inflamed. It is not a contagious condition and cannot be passed from one individual to another, though it is common with an estimated 1 in 20 cases of eye problems diagnosed by GPs in the UK being blepharitis. The condition tends to be more common in people over the age of 50, but it can affect people of all ages. Blepharitis cannot be cured and it tends to reappear; however in most cases it is a mild condition.

Types of blepharitis

There are two different types of blepharitis, which include:

• Anterior blepharitis

  this condition affects the outer rim of the eyelids.

• Posterior blepharitis

  this condition affects the meibomian glands, which are located on the inside of the front of the eyelids.

What causes blepharitis?

Anterior blepharitis

The most common cause of anterior blepharitis is a bacterial infection and in most cases the infection is caused by a strain of bacteria known as staphylococcus. Anterior blepharitis can also be caused by a common skin condition called seborrhoeic dermatitis, which can cause oily and flaky skin on the scalp. This type of blepharitis is known as seborrhoeic blepharitis.

Posterior blepharitis

Posterior blepharitis is caused by conditions that affect the meibomian glands, which are responsible for producing an oily substance to clean the eyes. Seborrhoeic dermatitis can cause both anterior and posterior blepharitis, and another skin condition known as rosacea can also cause posterior blepharitis; rosacea causes red patches to develop in the skin.

Less common causes of blepharitis include:

• Allergic reactions.
• Lice in the eyelashes.

Symptoms of blepharitis

Many people who have blepharitis experience bouts of symptoms followed by a long period without any telltale signs. Symptoms can vary according to the individual and the cause of the condition, though common symptoms include:

• Itchy eyes.
• Sore eyelids.
• Crusty eyelashes.
• Losing eyelashes.
• Heightened sensitivity to light (known as photophobia).
• Eyelids sticking together (this is most common when you wake up).
• A burning sensation in the eyes.

Blepharitis can be caused by seborrhoeic dermatitis and rosacea. Symptoms of seborrhoeic dermatitis include oily skin and flaky scalp, while symptoms of rosacea include red, flushed skin and spots.

The condition can also cause dry eye syndrome, which occurs when there is a shortage of tears. Dry eye syndrome can cause sore and red eye, watery eyes and a feeling of dryness in the eyes that gets worse as the day progresses.

How is blepharitis treated?

There is no cure for blepharitis but there are things you can do to ease symptoms. The most important thing is to adopt a good daily cleaning routine, which should involve

• Placing a warm cloth on your eyes when they are shut.
• Gently rubbing the cloth over your eyelids.
• Gently rubbing some cleaning solution (either baby lotion, sodium bicarbonate or a commercial eyelid cleaning agent – your GP will be able to recommend suitable products) on your eyelids.
• Clean your eyes in front of a mirror to reduce the risk of damaging your eyes.
• Avoid using eye make-up, especially eyeliner.

If cleaning the eyelids does not help a GP may prescribe antibiotics, which will usually include fusidic eye drops or chloramphenicol ointment. If you are using eye drops or ointment you should avoid wearing contact lenses during treatment.

If blepharitis is caused by seborrhoeic dermatitis you may be advised to use an anti-dandruff shampoo.