Specialist Ophthalmic & Oculoplastic Surgeon

Blepharitis is an inflammatory condition of the eyelids. It is frequently subdivided into front (anterior) and back (posterior) sub-types, although an individual could have both conditions simultaneously. Depending on your clinical findings, treatment may be tailored to address one component over the other.


What are the symptoms?

There are many different symptoms which this condition can cause, including itching, burning, smearing of vision (which can be blinked away), watering, dryness, soreness amongst others. It can also induce changes on the surface of the eye, the conjunctiva, the skin surrounding the eyelids and, occasionally, further afield. There are other conditions, including dermatological and systemic, which can also influence the course of the condition. 

How can Blepharitis be treated?

Some types of blepharitis have a bacterial component and treatment in the form of antibiotics may be required in the very short term. However, since the bacteria do not generally cause infection, this is rarely the sole or primary form of therapy. There is often notable inflammation as well and so various options, including medicinal, can be used to help control this. Blepharitisis usually a long-term condition and is very difficult to eradicate, treatment is only successful if you clean your eye lids regularly, as instructed. The cleaning of your eyelids should become part of your daily hygiene routine.

Possible Treatments for Blepharitis

The aim of this exercise is to warm the eyelids (and hence the oils within them) so that they can be expressed more easily (similar to how warm candle wax flows more easily than cool wax)because when the eyelid oils do not flow easily, this can cause inflammation which, in turn, can cause some of the symptoms you are suffering from. The eye bags come in different forms, including ones that can be placed in a microwave (similar to those used in spa therapies)or that that use a heating element which can be plugged into the wall or via a USB port. Hot flannels can also be used (like those served in some restaurants at the end of a meal) but these tend to cool rapidly and so their effects are shorter lived. These are usually rested on the face for a few minutes ahead of hot compression. Sensible care to avoid overheating and burning must be undertaken at all times. Under take this one to two times a day. 

The aim of hot compression is to express the warmed oils. The eyelids contain numerous vertical glands (that point towards the eye)and the oil gland openings sit just behind the eyelashes. Each of these has the potential to swell and potentially block, which can lead to cyst formation and local inflammation. If the oils are altered or stagnate then irritation can arise and helping get the oils flowing again is the key part of this task. Think of trying to express toothpaste out of a tube when the cap has been left off overnight–this is helped by a combination of warming and pressure in the direction of the nozzle. For hot compression, use around handled metallic spoon which has been warmed in a cup of warm tap water (only warm enough that you can put your finger in without needing to take it out) for about one minute. Metallic spoons are helpful because they retain they heat well and also have a shape that fits well on the eyelid. Using the handle on the eyelid use a rolling motion towards the eyelid margin (where the lashes join the skin)-upwards for the lower lids and downwards for the upper lids. Do this for about two minutes one to two times a day.

1. Use a round-ended teaspoon or the rounded head of the spoon.

2. Dip the spoon into a bowl of steaming water.

3. Keeping the eye closed, raise the spoon to the affected eye, massage the area with the round end or head of spoon.

4. As the spoon cools, re-dip it in the steaming water and repeat.

5. Repeat for 10-15 minutes and do this 2-3 times daily.

Bathing helps with the more anterior (front) blepharitis and involves an action similar to that which is undertaken to remove mascara. A side-to-side scrubbing action aimed at removing very small particulate debris at the roots of the eyelashes is undertaken using either a pre-formulated wipe, a make-up pad remover or cotton bud with baby shampoo.

Items required:

Make-up remover pad–available from most chemists and supermarkets

Baby Shampoo–1 part shampoo to 9 parts water


Soak the cotton bud in the solution of baby shampoo and scrub both the upper and lower lid margins. Look away from the direction of the make-up remover pad to avoid poking yourself in the eye. You must do this thoroughly, spending around 30 seconds on each eyelid. This is best done using a small shaving/make-up mirror. This should be done three times a day for four weeks, followed by twice a day for the next four weeks, and then once per day as specified for you in the short to medium term.

If you have been prescribed antibiotic ointment for your eyelids, squeeze a little of this onto your clean fingertip and rub it along the upper and lower lid margins. 

Talk to us today about Blepharitis treatments and what's right for you.