What are the causes of Blepharitis ?

This post is about understanding what are the main causes of blepharitis. Blepharitis is an irritation or inflammation of the eyelids.

Causes of blepharitis

Causes of blepharitis

There are several kinds of blepharitis and the causes of blepharitis can greatly vary, but the most common are anterior and posterior. Posterior blepharitis affects the inner surface of the eyelid that comes in contact with the eye. It is usually caused by problems with the oil (meibomian) glands in the lid margin. With posterior blepharitis, there is a sandy gritty irritation in the morning with or without redness that goes away by breakfast. This is caused by inflammation under the eyelids irritating the eyes all night, but then the tears wash away the inflammation quickly after eye opening. Left untreated, posterior blepharitis can lead to loss of the meibomian oil glands and permanent evaporative dry eye.

Anterior blepharitis is much easier to see as it affects the front of the eyelids, usually near the eyelashes and looks like dandruff where the eyelashes meet the eyelid.

The two most common causes of anterior blepharitis are bacteria and a skin disorder called seborrheic dermatitis, which causes itchy, flaky red skin. Left untreated, anterior blepharitis can lead to posterior blepharitis and permanent evaporative dry eye. Most eye care professionals suggest warm compresses to treat both anterior and posterior blepharitis.

Blepharitis can be seen in two différents forms:

  • Anterior blepharitis, affecting the outside front of the eyelid where eyelashes are attached.
  • Posterior blepharitis, linked to dysfunction of meibomian glands within the eyelids that secrete oils to help lubricate the eye.

It’s common to have a mixture of both anterior and posterior forms of blepharitis at the same time, but in different degrees of severity.

Blepharitis can cause inflamed eyelids, eye burning and dryness.

Although eye doctors commonly diagnose blepharitis, it can be difficult to find permanent relief of the symptoms that can include burning, flaking, crusting, tearing, irritation, itching, redness in eyelid margins and a foreign body sensation.

Treatment for Blepharitis

If you have a chronic blepharitis, your doctor will recommend eyelid hygiene regimen. Eyelid hygiene is the central treatment in almost all cases of blepharitis. Besides a eyelid hygiene regimen, the severity of the blepharitis and related symptoms may require supplemental treatment with topical and oral medicine. In some cases of posterior blepharitis, eye doctors recommend nutritional supplementation with omega-3 fatty acids, such as flaxseed oil, to aid healthy function of meibomian glands that provide essential lubrication for eye and eyelid comfort.

Posterior Blepharitis

Also know as meibomian gland dysfunction (MGD), this disease reduces meibomian gland output or produces abnormal oily secretions. Symptoms of posterior blepharitis include inflamed and thickened eyelid margins, eyelid crusting and other symptoms that are often difficult to manage. This type of blepharitis is often named “evaporative dry eyes”.

Rosacea blepharitis

People with facial rosacea can unfortunately experiment ocular rosacea. The symptoms related to ocular rosacea are very similar to meibomian gland dysfunction  with eyelid inflammation. Warm compresses and eyelid hygiene is also the central treatment for this type of blepharitis.


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