Formula Medical Group
Apple Valley, CA
760-242-1234


James Krider, MD


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Inflamed eyelids - Blepharitis

What are inflamed eyelids?

Eyelid inflammation is characterized by redness and irritation of the lid margin — the edge of the eyelid beneath the eyelashes. The condition, known medically as blepharitis, also causes scaling of the skin at the lid margin. In the most severe form of the disorder — ulcerative blepharitis — tiny ulcers form along the eyelid.

Blepharitis is most likely to occur in people who have dandruff or who have a history of sties (infected eyelash follicles), chalazions (blocked glands in the eyelid), eczema, or various skin allergies.

SYMPTOMS

  • Red, itchy, or stinging eyelid edges.
  • Scaling of the skin at the eyelid margins.
  • A gritty sensation, as if sand is in the eye.
  • A swollen eyelid.
  • Tiny ulcers at the lid margins.
  • Loss of eyelashes.
  • Watery eyes.
  • Sensitivity to light.
  • Discharge from the eye that causes lids to stick together during sleep.

What causes inflamed eyelids?

Ulcerative blepharitis is caused by bacterial infection (most often with staphylococcal bacteria) in the eyelash follicles and the adjacent glands. This bacterium normally lives on the skin and can cause infection if it gains access to the sweat glands and other structures of the skin.

Milder cases of blepharitis may result from allergic reactions or arise in conjunction with seborrhea (overactivity of the oil glands, causing scales and itching) of the face and scalp. In some cases, the cause of blepharitis remains unknown.

How are inflamed eyelids diagnosed and treated?

You can usually self-diagnose blepharitis on the basis of your symptoms and the appearance of your eyelids. If the inflammation persists or if it is accompanied by a discharge from the eyes, a laboratory culture may be ordered to identify the causative organism. In such cases, an antibiotic cream and/or eye drops usually clear up the infection.

What can I do myself?
Wash away the scales with warm water and gentle scrubbing with a washcloth every morning and evening.

An inflamed, irritated eyelid characterizes blepharitis. In severe cases, tiny ulcers form along the eyelid's edge.

An inflamed, irritated eyelid characterizes blepharitis. In severe cases, tiny ulcers form along the eyelid's edge.

Apply warm, wet compresses to your closed eyes for 10 to 20 minutes every 2 or 3 hours during the course of a day. Compresses soaked in a mild solution of baking soda and water may be particularly soothing. Avoid eye makeup as long as your eyelids are inflamed.

When should I see my doctor?
Consult a doctor if self-care does not resolve inflamed eyelids within a week or so. See a doctor sooner if your eyes begin to bleed or become painful or if your vision is impaired.

What will the doctor do?
If the inflammation is due to blepharitis, a special antibiotic eye ointment containing erythromycin or bacitracin may be prescribed. In a typical regimen, the ointment is applied to the affected area of the lid three times a day after warm compresses have been applied to the eye for 10 minutes.

If the doctor suspects that your inflamed eyelids are secondary to an underlying allergy, infection, or other skin condition, that disorder will also require treatment.

If your cornea (the clear membrane that arches over the pupil and colored part of the eye) or conjunctiva (the membrane that lines the eyelid and covers the white of the eye) has also become irritated or infected, prescription eye drops

An infected gland in the skin (a chalazion) is a common cause of inflamed eyelids.
An infected gland in the skin (a chalazion) is a common cause of inflamed eyelids.

containing a sulfa drug and a steroid may be prescribed.

This regimen usually clears up inflamed eyelids within a week or two. If prolonged treatment with steroids is necessary, regular visits to an eye specialist are needed to monitor for possible adverse effects.

The course of inflamed eyelids

Inflamed eyelids can be difficult to treat. Even after blepharitis seems to have been cured, it often recurs, and such recurrences can be highly resistant to treatment. Sometimes treatment for as long as a year is needed to obtain complete relief.

Although recurrences of nonulcerative blepharitis do not threaten vision, they can be uncomfortable and unsightly. Recurrent ulcerative blepharitis, however, may have serious, long-term effects. The infection may cause the eyelashes to fall out and leave permanent scars on the eyelids. Occasionally, it leads to corneal ulceration, which can quickly damage vision.

Are inflamed eyelids dangerous?
Usually, no. But if the infection spreads to the cornea, it may cause painful, potentially damaging ulcers. The bacteria are most likely to spread to the cornea when skin flakes fall into the eye and are not removed promptly, irritating the conjunctiva and cornea. You must treat corneal ulcers promptly to avoid loss of vision.

What can I do to avoid inflamed eyelids?

  • If you have dandruff, seborrhea of the face or scalp, or any other skin rash or inflammation, follow your doctor's recommendations for appropriate self-care measures to control it.
  • Never use another person's eye makeup or eye lash curlers.
  • Throw out unused eye makeup every 6 months to avoid the risk of infection.
  • Protect your eyes from irritants such as smoke and chemicals.
This article was last reviewed December 1, 2005 by Dr. James Krider.
Reproduced in part with permission of Home Health Handbook.
Allergic reaction
Seborrhea
Staphylococcal bacteria


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