Blepharitis - Diagnosis and treatment (2023)


Tests and procedures used to diagnose blepharitis include:

  • Examining your eyes. Your doctor might use a special magnifying instrument to examine your eyelids and your eyes.
  • Swabbing skin for testing. In certain cases, your doctor might use a swab to collect a sample of the oil or crust that forms on your eyelid. This sample can be analyzed for bacteria, fungi or evidence of an allergy.


Self-care measures, such as washing your eyes and using warm compresses, might be all that's needed for most cases of blepharitis. If self-care measures aren't enough, your doctor might suggest prescription treatments, including:

  • Medications that fight infection. Antibiotics applied to the eyelid have been shown to provide relief of symptoms and resolve bacterial infection of the eyelids. These are available in several forms, including eyedrops, creams and ointments.

    If you don't respond to topical antibiotics, your doctor might suggest an oral antibiotic.

  • Medications to control inflammation. Steroid eyedrops or ointments are used for this, generally only for people who don't respond to other therapies. Your doctor might prescribe both antibiotic and anti-inflammatory drugs.
  • Medications that affect the immune system. Topical cyclosporine (Restasis) has been shown to offer relief of some signs and symptoms of blepharitis.
  • Treatments for underlying conditions. Blepharitis caused by seborrheic dermatitis, rosacea or other diseases might be controlled by treating the underlying disease.

Other treatment options, such as using intense pulsed light might unclog the glands. More study is needed.

Blepharitis rarely disappears completely. Even with successful treatment, the condition frequently is chronic and requires daily attention with eyelid scrubs. If you don't respond to treatment, or if you've also lost eyelashes or only one eye is affected, the condition could be caused by a localized eyelid cancer.

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(Video) Blepharitis, Causes, Signs and Symptoms, Diagnosis and Treatment.

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(Video) What is Blepharitis? (How to Treat Blepharitis at Home)

Lifestyle and home remedies

Self-care measures might be the only treatment needed for most cases of blepharitis.

Clean your eyes daily

If you have blepharitis, follow this self-care remedy two to four times a day during flare-ups and once or twice a day after the condition is under control:

(Video) What Is Blepharitis? (Blepharitis Explained - Best Treatments)

  • Apply a warm compress over your closed eye for a few minutes to loosen the crusty deposits on your eyelids.
  • Firmly but gently massage the eyelids, using a clean washcloth or a clean finger.
  • Immediately use a clean washcloth or cotton-tipped applicator moistened with warm water and a few drops of diluted baby shampoo or an over-the-counter eyelid cleanser to wash away oily debris or scales at the base of your eyelashes. Use a different clean cloth for each eye.
  • In some cases, you might need to be more deliberate about cleaning the edge of your eyelids at your eyelashes. To do this, gently pull your eyelid away from your eye and use the washcloth to gently rub the base of the lashes. This helps avoid damaging your cornea with the washcloth.

    Ask your doctor whether you should use a topical antibiotic ointment after cleaning your eyelids in this way.

  • Rinse your eyelids with warm water and gently pat them dry with a clean, dry towel.

It might help to stop using eye makeup when your eyelids are inflamed. Makeup can make it harder to keep your eyelids clean and free of debris. Also, it's possible that makeup could reintroduce bacteria to the area or cause an allergic reaction.

Lubricate your eyes

Try over-the-counter artificial tears. These eyedrops can help relieve dry eyes.

Control dandruff and mites

If you have dandruff that's contributing to your blepharitis, ask your doctor to recommend a dandruff shampoo. Using a dandruff shampoo might relieve your blepharitis signs and symptoms.

Using tea tree oil shampoo on your eyelids daily might help deal with mites. Or try gently scrubbing your lids once a week with 50% tea tree oil, which is available over-the-counter. Contact your doctor if you don't see improvement in six weeks. And stop using tea tree oil if it irritates your skin or eyes.

Alternative medicine

No alternative medicine treatments have been proved to ease the symptoms of blepharitis. However, a diet rich in omega-3 fatty acids or supplements containing omega-3 fatty acids might help blepharitis associated with rosacea. Omega-3 fatty acids are found in foods such as salmon, tuna, trout, flaxseed and walnuts. More study is needed.

(Video) Causes of blepharitis and how to treat it

Preparing for your appointment

You're likely to start by seeing your family doctor. If your doctor suspects you may have an eyelid problem, such as blepharitis, you might be referred to an eye specialist (optometrist or ophthalmologist).

Here's some information to help you get ready for your appointment.

What you can do

Make a list of the following:

  • Your symptoms, including any that may seem unrelated to blepharitis, and when they began
  • All medications, vitamins or other supplements you take, including doses
  • Questions to ask your doctor

For blepharitis, questions to ask your doctor include:

  • What is likely causing my symptoms?
  • What are other possible causes for these symptoms?
  • What medical conditions can cause this problem?
  • What tests will I need?
  • Should I see a specialist?
  • Are there brochures or other printed material I can have? What websites do you recommend?
  • Can I continue to wear contact lenses?
  • Do I need to take special care cleaning my contact lenses and my carrying case?
  • Can I continue to wear eye makeup?
  • Will I need a follow-up visit? If so, when?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, such as:

  • Do your symptoms come and go, or do you always have them?
  • Are your symptoms worse in the morning or later in the day?
  • Have you been wearing contact lenses?
  • Have you changed cosmetic brands recently?
  • Have you changed soap or shampoo brands recently?
  • Does anything seem to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Has anyone close to you had a recent eye infection?
  • Have you ever had any eye diseases, eye surgeries or eye injuries?
  • Do you have other diseases or conditions?

What you can do in the meantime

While waiting for your appointment, you might find relief from eye irritation by gently washing your eyelids a few times each day. To wash your eyelids:

(Video) What is blepharitis and how is it treated?

  • Apply a warm washcloth to your closed eyelids for up to five minutes.
  • Gently rub your closed eyelids with a diluted solution of baby shampoo. Use a clean washcloth or clean fingers. You might need to hold the lid away from your eye to rub along the lash margin. Removing the scales might require several minutes of gentle rubbing.
  • Rinse your eyes thoroughly with warm water.

Avoid anything that irritates your eyes, such as eye makeup and contact lenses.

By Mayo Clinic Staff


What is the most effective treatment for blepharitis? ›

A GP might suggest using an antibiotic cream or ointment that you rub on your eyelid if your blepharitis does not clear up after cleaning your eyelids regularly. If blepharitis has caused other problems, such as a lump of fluid under the skin (cyst), antibiotic eyedrops or tablets may be recommended.

How do you diagnose blepharitis? ›

Blepharitis can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on the eyelids and the front surface of the eyeball, may include: Patient history to determine any symptoms the patient is experiencing and any general health problems that may be contributing to the eye problem.

What is the first line treatment for blepharitis? ›

Primary treatment for blepharitis is lid hygiene involving hyperthermic lid compress, lid margin massage with lash scrubs lasting 3–5 minutes at least two times daily during the acute presentation.

What is the main cause of blepharitis? ›

Blepharitis (blef-uh-RYE-tis) is inflammation of the eyelids. Blepharitis usually affects both eyes along the edges of the eyelids. Blepharitis commonly occurs when tiny oil glands near the base of the eyelashes become clogged, causing irritation and redness.

What can an ophthalmologist do for blepharitis? ›

For people with severe cases of blepharitis, Columbia ophthalmologists might prescribe antibiotic medications or steroid eyedrops. For people who also have scalp dandruff, the doctor might recommend a dandruff shampoo to help with treatment. People who also have acne rosacea should have that condition treated as well.

What deficiency causes blepharitis? ›

Other dermatological manifestations of vitamin A deficiency include blepharitis [16], noted in our first patient, and cheilitis.

What type of bacteria causes blepharitis? ›

The most common bacteria in chronic blepharitis include Staphylococci, Corynebacterium, and Propronibacterium species (Dougherty and McCulley, 1984; Teweldemedhin et al., 2017).

What ointment is good for blepharitis? ›

Topical antibiotics should be used in all cases of acute blepharitis and cases of anterior blepharitis. They have been found to be useful in symptomatic relief and eradicating bacteria from the lid margin. Topical antibiotic creams like bacitracin or erythromycin can be applied to the lid margin for 2 to 8 weeks.

Which antibiotic is best for blepharitis? ›

Oral tetracycline or doxycycline may be effective for people with posterior blepharitis or symptoms not adequately controlled by lid hygiene and topical medications, especially those with concurrent MGD (AAO 2018).

How do I get rid of blepharitis permanently? ›

You can't cure blepharitis. However, it can be treated and controlled through proper eyelid hygiene. Left untreated, blepharitis may lead to other more serious eye conditions, including corneal problems, which may be significant.

What is the best over-the-counter medicine for blepharitis? ›

To treat blepharitis, wipe eyelids and lashes with Cliradex wipes twice a day for 10 days. If symptoms do not clear up, continue to use Cliradex wipes once a day for another 10 days. Cliradex is safe for everyday use and also works to remove eye makeup.

Why won't my blepharitis go away? ›

Many patients struggle with itchy, inflamed, crusty eyelids that no matter how much they perform lid scrubs or warm compresses will not resolve. The problem is often associated with a parasitic mite called Demodex that infests the eyelashes.

What foods to avoid if you have blepharitis? ›

Reduce consumption of wheat, flour and sugar. Limit alcohol intake. Avoid foods rich in fructose, cream, butter and margarine (saturated fats!)


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