Anterior blepharitis is a common, chronic inflammation of the eyelids, affecting the eyelid margins where eyelashes grow. While not contagious or vision-threatening, it causes discomfort. It is characterized by redness, irritation, itching, and often dandruff-like scales on the eyelashes.
Recognizing Anterior Blepharitis
Symptoms of anterior blepharitis include red, swollen eyelids and a persistent itching or burning sensation. A gritty feeling, as though something is in the eye, is common.
Frequent flaking or crusting around the eyelashes, especially upon waking, can cause eyelids to stick together. Watery eyes and light sensitivity can also occur. Symptoms vary from minor irritation to pronounced discomfort.
What Leads to Anterior Blepharitis
Anterior blepharitis primarily stems from two main causes: bacterial overgrowth or underlying skin conditions. Staphylococcal blepharitis results from an overgrowth of Staphylococcus bacteria on the eyelids. While these bacteria are naturally found on the skin, an overgrowth can trigger an inflammatory response.
Another common cause is seborrheic blepharitis, associated with dandruff or oily skin conditions like seborrheic dermatitis. In this type, greasy flakes and scales accumulate on the eyelids, contributing to inflammation. Less common causes include allergies, particularly to cosmetics or contact lens solutions, and infestations by tiny mites on the eyelashes.
Managing and Treating Anterior Blepharitis
Home care is the first step in managing anterior blepharitis. Applying warm compresses to the closed eyelids for 5 to 10 minutes softens crusts and oily secretions. Repeat several times daily during flare-ups, and once or twice daily for ongoing management.
Gentle eyelid hygiene follows warm compresses. Using a clean washcloth or cotton-tipped applicator moistened with diluted baby shampoo or a specialized over-the-counter eyelid cleanser removes oily debris and scales from the base of the eyelashes. Gently rub along the lash margin, avoiding excessive soap or direct contact with the eyeball.
For persistent or severe cases, a doctor may prescribe medical treatments. Topical antibiotic ointments or drops, such as erythromycin or bacitracin, can be applied to the eyelid margins to reduce bacterial load and alleviate symptoms. Anti-inflammatory medications, like steroid eye drops or creams, may be used short-term to control inflammation. Oral antibiotics may be considered if topical treatments are ineffective or if the condition is linked to underlying skin issues like rosacea.
Living with Anterior Blepharitis
Long-term management involves consistent eyelid hygiene to prevent flare-ups, as the condition is chronic and may recur. Continuing daily warm compresses and gentle eyelid cleansing, even with minimal symptoms, maintains eyelid health. Regularly replacing eye makeup also helps prevent recontamination.
Addressing underlying skin conditions like dandruff or rosacea can further manage blepharitis symptoms. Using a dandruff shampoo for scalp issues may improve eyelid health. Consult an eye care professional if symptoms worsen, do not improve with home care after several weeks, or if vision changes occur.