Blepharitis is an inflammation of your eyelids. It can make eyelids red and eyelashes crusty, and make your eyes feel irritated, itchy or watery.

It can also lead to burning, soreness or stinging in your eyes or puffiness of the eyelids. It can make you more susceptible to styes (hordeola) or eyelid cysts (chalazia). The symptoms are often worse in the morning, and when you wake up you may find your lids are stuck together. Blepharitis is a chronic (long-term) condition that normally affects both eyes. This means that once you have had it, it can come back even after it has cleared up. You can usually manage it by keeping your eyelids clean. You may need to do this for several months to see a benefit.

Even though your eyes may be watery, blepharitis actually causes a type of dry eye. The reason for this is that blepharitis causes poor quality tears to be produced. Because of a lack of oils in the tears, they evaporate too quickly drying out the eye surface, meaning that the lacrimal (water) gland needs to produce more tears. This, in turn, leads to tears which evaporate too quickly. There are two main types of blepharitis:

Anterior blepharitis – this affects the outside edge of your eyelids (near or among your eyelashes).

Posterior blepharitis – this is also called meibomian gland dysfunction (MGD) and affects the inside rim of your eyelids just behind your eyelashes, which contains your meibomian glands. Your meibomian glands produce the oily part of your tears.


Who is at risk of blepharitis?
Blepharitis is more common in people over 50, but it can develop at any age. As you get older the glands in your eyelids that secrete part of your tears become blocked more easily. You are also more susceptible to blepharitis if you have rosacea or seborrheic dermatitis.

How will I know I have blepharitis?
Your optometrist will be able to tell if you have blepharitis by looking at the eyelids under a slit lamp, and from your symptoms.

How should I look after my eyes if I have blepharitis?
It is possible to make your eyes more comfortable, but it is usually difficult to eradicate fully. If you have blepharitis avoid eye make-up (particularly on the inside edge of the eyelids) and smoky atmospheres.

There are treatments which can help you reduce the effects of blepharitis. You may need treatment for several months:

1. Warm compresses

Warm compresses work by warming the material that blocks the glands and loosening the crusts on the eyelid, making them easier to remove. Reusable warming packs that you heat up in the microwave can be bought in-practice. We stock the Optase Moist Heat Mask and the EyeBag. You should aim to keep the pack on your eyes for about 10 minutes. Sometimes warm flannels are recommended. While they provide a cheaper alternative they do not hold their heat for the full 10 minutes and can leave you with a wet pillow! 10 minutes twice a day is the aim to begin with, but you can reduce to once a day when your symptoms start to resolve.

2. Lid cleaning

What should I use?
Traditionally, patients have been recommended baby shampoo to clean the eyelids however this (despite it’s “no tears” claims!) can cause the eyes to sting. We also find that patients find mixing a solution themselves a hassle and often do not stick to the treatment because of this. We recommend using a lid wipe or solution that has been specifically designed for blepharitis. You can buy pre-wetted wipes or solutions in-practice. In some cases treatment with tea tree oil is beneficial. This is used in particular forms of blepharitis and your optometrist will decide if this is appropriate.

What should I do?

At home treatments
Use a lid-cleaning wipe or a cotton-wool pad dampened in solution to gently clean the edges of your eyelids near your lashes. Wipe from the inside (near your nose) to the outside corner of your eye. Be careful not to clean inside your eyelid or to touch the surface of your eye with the wipe or cotton-wool bud. If you use pre-wetted wipes, use one side for each eye. Repeat this twice a day at first and reduce this to once a day as the condition improves.

In-practice treatment
We are also delighted to be the first and only practices in Ceredigion to offer the innovative ‘BlephEx’ treatment, a piece of technology that is used by your optometrist to very precisely and carefully spin a medical grade micro-sponge along the edge of your eyelids and lashes, removing scurf and debris and exfoliating your eyelids. This offers you a head start in your lid cleaning or is useful as a top-up to your home treatments. We usually recommend that it is repeated every 6 months.

“Up to now, we have only been able to advise patients on how to clean their eyelids at home, however this piece of kit gives us a fantastic opportunity to manage blepharitis in-practice, giving patients a jump start in the management of their condition.” - Ceri Probert, Specialist Optometrist & Director

To experience the benefits of the tool first hand or if you have any further questions please contact the Aberystwyth practice. More information can also be found at

3. Artificial tear supplements

For the relief of dry eye secondary to blepharitis you can use various eye drops, gels, ointments and sprays. We stock a wide variety of these, and your optometrist can recommend the one that is best for you.

4. Other treatments

There is some evidence that omega 3 supplements are beneficial in those with blepharitis and you can buy these in pharmacies and supermarkets. However, there is limited evidence about the exact dose required. Some patients have also found that gentle face washes and shampoos containing tea tree oil are a useful addition to your blepharitis management. If the treatments above do not work, it may be useful for your optometrist to prescribe you antibiotic tablets. Sometimes antibiotic drops or ointments work too, and you may need to take these for several weeks or months. Ceri and Lisa are independent prescribing optometrists and will be able to prescribe these if required. If you have any concerns about the health of your eyes, please call us to book an appointment. We are able to offer you consultation for any queries you may have about your eyes.

Text adapted from the College of Optometrists