[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Conditions](https://durgical.com/en/conditions/) › Blepharitis # Blepharitis Chronic inflammation of the eyelid margins, with crusty lashes and burning, gritty eyes. It is controlled with daily lid hygiene rather than cured. Updated Nov 5, 2026 ## Quick facts **Key signs** Burning · Red · Crusts or scales at the base **Diagnosis** Clinical Red flags ↓ No doses: the clinician sets them by the current guideline. On this page - The basics What it is - Who gets it - Causes - Risk factors - Pathophysiology - Classification - Why it happens - Clinical Symptoms and signs - Red flags - Diagnosis - Differential diagnosis - Complications - Prognosis - Treatment Goal of treatment - Treatment - Prevention - Study Test yourself - Connections Connections ## What it is A common, chronic inflammation of the eyelid margins. Anterior blepharitis affects the base of the lashes (staphylococcal or seborrhoeic); posterior blepharitis is meibomian gland dysfunction, which thickens the oily secretions and destabilises the tear film. It causes long-lasting irritation but rarely threatens sight. See it in 3D - [Eyelids](https://durgical.com/en/anatomy/superior-tarsus/) - [Cornea](https://durgical.com/en/anatomy/cornea/) - [Lacrimal gland](https://durgical.com/en/anatomy/lacrimal-gland/) ## Who gets it One of the most frequent reasons for eye consultations at all ages, more common in older adults and in people with rosacea or seborrhoeic dermatitis. ## Causes - Staphylococcal colonisation of the lid margin - Seborrhoeic dermatitis - Meibomian gland dysfunction - Demodex mites in the lashes - Rosacea ## Risk factors - Rosacea and seborrhoeic dermatitis - Older age - Contact [lens](https://durgical.com/en/anatomy/lens/) wear - Dry eye - Isotretinoin treatment ## Pathophysiology Bacteria, mites and abnormal gland secretions inflame the lid margin. Thickened meibomian oil no longer covers the tears, which evaporate quickly; the unstable tear film and bacterial toxins irritate the conjunctiva and [cornea](https://durgical.com/en/anatomy/cornea/), closing a cycle of chronic inflammation. ## Classification - Anterior (staphylococcal or seborrhoeic) - Posterior (meibomian gland dysfunction) - Mixed ## Symptoms and signs - Burning, grittiness and itching, worse in the morning - Red, thickened lid margins - Crusts or scales at the base of the lashes - Watery or slightly sticky eyes - Fluctuating blurred vision that clears with blinking ## Red flags - Painful red eye with reduced vision or light sensitivity (keratitis) - Loss of lashes or a persistent lid nodule in one place (possible tumour) - Recurrent chalazion in the same site ## Diagnosis **Clinical** Clinical diagnosis by examining the lid margins, lashes and meibomian gland openings, ideally with a slit lamp; the tear film break-up time is often short. **Tests** Biopsy only for a unilateral, persistent or nodular lesion, to rule out a sebaceous gland carcinoma. **Imaging** Not needed. ## Differential diagnosis - Dry eye disease - Allergic conjunctivitis - Sebaceous gland carcinoma (unilateral, persistent) - Contact dermatitis of the lids ## Goal of treatment Control symptoms with long-term lid hygiene and treat the associated [skin](https://durgical.com/en/anatomy/skin/) disease and dry eye. ## Treatment **Conservative** Warm compresses and gentle lid massage, then cleaning of the lid margins, every day for the long term. **Conservative** Preservative-free lubricant eye drops for associated dry eye. **Medical** Topical antibiotic ointment on the lid margins for marked anterior blepharitis, for a limited period. **Medical** Oral tetracyclines or macrolides at low doses in meibomian gland dysfunction or rosacea, prescribed by a doctor. ## Complications - Recurrent chalazia and styes - Marginal keratitis and corneal infiltrates - Loss or misdirection of lashes - Chronic conjunctivitis ## Prognosis Chronic and relapsing, but well controlled when lid hygiene is kept up. ## Prevention - Daily lid hygiene in predisposed people - Treating rosacea and seborrhoeic dermatitis - Removing eye make-up every night ## Test yourself Think of the answer, then tap the question to see it. ## What is posterior blepharitis? Meibomian gland dysfunction: thick secretions that destabilise the tear film. ## What is the mainstay of blepharitis treatment? Daily, long-term lid hygiene with warm compresses and cleaning. ## Which lid finding requires a biopsy? A unilateral, persistent lid thickening or loss of lashes, to rule out a tumour. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/conditions/blepharitis/) ## Why it happens - [Tumours of the eyelid and conjunctiva](https://durgical.com/en/general-pathology/tumours-of-the-eyelid-and-conjunctiva/) ## Connections ## Microorganisms that cause it 1 - [Demodex folliculorum and Demodex brevis](https://durgical.com/en/microbiology/demodex-folliculorum-and-demodex-brevis/) ## Related conditions 4 - [Dry eye disease](https://durgical.com/en/conditions/dry-eye-disease/) - [Chalazion and hordeolum (stye)](https://durgical.com/en/conditions/chalazion-and-hordeolum/) - [Conjunctivitis](https://durgical.com/en/conditions/conjunctivitis/) - [Keratitis and corneal ulcer](https://durgical.com/en/conditions/keratitis-and-corneal-ulcer/) Educational information, not medical advice. For any symptom, see a health professional. Sources: [Blepharitis](https://www.ncbi.nlm.nih.gov/books/NBK459305/) (StatPearls Publishing (NCBI Bookshelf), 2025). 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