Blefaritis

Blefaritis is a chronic inflammatory condition of the eyelid margins, typically presenting with redness, irritation, crusting, and flaking around the eyelashes. It is one of the most common ocular surface disorders and can be persistent or recur despite treatment. Blefaritis may affect the anterior lid margin near the eyelashes or the posterior lid margin where the meibomian glands reside.

Causes are multifactorial. Bacterial colonization, particularly Staphylococcus species, seborrheic dermatitis, and meibomian gland dysfunction are frequent contributors. Other factors include rosacea, allergic conjunctivitis, and Demodex mite infestation, which can worsen symptoms and lid margin inflammation.

Symptoms commonly include burning or grittiness, itching, tearing, lid swelling, crusting or sticking of lids, and sensitivity to light. Signs observed on examination include lid margin redness, telangiectasia, and irregular or blocked meibomian glands. Diagnosis is clinical, supported by slit-lamp examination of the lid margins and glands.

Treatment focuses on lid hygiene and addressing contributing factors. Daily lid hygiene with warm compresses and lid scrubs helps to loosen crusts and unblock glands. Inflammatory symptoms may be managed with short courses of topical glucocorticoids under supervision. Bacterial blepharitis may require topical antibiotics, either alone or combined with anti-inflammatory therapy. Meibomian gland dysfunction often benefits from oral doxycycline or other tetracyclines in adults, especially during flare-ups. Demodex-related blepharitis may respond to tea tree oil-based lid care. Treating associated skin conditions such as rosacea or seborrhea improves outcomes. In some cases, managing conjunctivitis and ensuring good eyelid hygiene reduces recurrence.

Prognosis is generally favorable with regular lid hygiene, but blefaritis is often chronic and prone to recurrent episodes. Prevention centers on consistent lid hygiene, avoiding eye rubbing, and minimizing irritants or contact lens use during flares.