Understanding Blepharitis: Causes, Symptoms, and Treatment

Blepharitis is one of the most common and underdiagnosed conditions I see in patients of all ages. It refers to the inflammation of the eyelid, but this doesn’t always mean the eyelids themselves are inflamed—this happens only in severe cases. More commonly, debris builds up along the base of the eyelashes, where the lashes grow. This buildup usually stems from environmental factors and poor eyelid hygiene. For example, people who work in dusty environments without proper eye protection and neglect to clean their lashes often have clumps of dirt stuck between their lashes.

Our eyes naturally produce oils to stabilize the tear film, but issues arise when debris clogs the glands or when the glands aren’t activated properly (a condition called meibomitis).

Symptoms of Blepharitis

Many people may have blepharitis without symptoms if the debris doesn’t irritate their eyes. However, symptomatic individuals often experience irritated, red, or itchy eyes. In severe cases, the debris buildup can cause the lashes to stick, clog the glands, inflame the eyelids, and lead to a total mess of symptoms. Blepharitis and meibomitis frequently trigger dry eye, so treating lid hygiene is the first step in addressing dryness.

Lid Hygiene Tips for Managing Blepharitis

To manage blepharitis, whether symptomatic or not, start by paying attention to eyelid hygiene. One simple approach is to use baby shampoo (or specific eyelid cleaning products, if necessary) and incorporate the following routine into your daily morning or night schedule:

• Apply a small dime-sized amount of baby shampoo to your closed eyelids.
• Gently rub it along the base of your lashes for 5–10 seconds.
• Rinse with warm water to remove debris.

For clogged glands (meibomitis), you’ll need a bit more effort. After cleaning your lids, use a warm compress. Invest in a heat-retaining eye mask and apply it to your eyes for 5–10 minutes to open up the glands. Follow with a gentle massage around the lash base using a warm cloth for another 3–5 minutes to clear the glands. This will help to open up the clogged glands and get rid of whatever is stuck in them. It is important to stick with the routine to ensure it doesn’t happen again.

The Importance of Proper Blinking

If you spend a lot of time in front of a screen, it’s crucial to monitor how often you blink. Studies show that computer users blink 50% less than they should, leading to an uneven tear film, which makes the eyes feel dry. Blinking not only spreads the tear film evenly but also activates the meibomian glands, which produce the oils needed for tear stability. Consider proper blinking as part of your routine. A full blink, where the top and bottom eyelids touch, activates the meibomian glands, which produce oils for tear film stability. Without enough pressure or when the lids don’t fully touch, the oil doesn’t get secreted, leading to a blockage. This disrupts the tear film’s stability, causing the tears to dry up faster than they should, which ultimately results in dryness. To ensure proper blinking:

• Place your fingers beside your eyes where the lids meet.
• Close your eyes until you feel the pressure move your fingers—this indicates a complete blink.

Repeat this about 10 times every 10 minutes while working at a computer.

Makeup Removal for Women

It’s essential to completely remove eye makeup before bed, especially if you use eyeliner along the waterline (“tight-lining”) or wear fake lashes. Tight-lining can clog the glands along the eyelid. Many women I’ve treated have makeup residue in their tear film, causing irritation. When wearing less make-up is not an option, my recommendation would be to be more careful with their application and try to avoid tight-lining if possible. Fake lashes also contribute to debris buildup, so it’s crucial to remove all glue before bed.

For those with eyelash extensions, take extra care to keep your lash line clean. Removing makeup can be tricky with extensions, but it’s important to ensure your lashes and lids are free of debris.

Eyelid Treatment at Wink Optometry

At Wink Optometry clinic in Burnaby, we offer IPL (Intense Pulsed Light) and RF (Radiofrequency) treatments for blepharitis and meibomitis. IPL reduces inflammation by targeting abnormal blood vessels, while RF uses heat to unclog meibomian glands and improve oil flow. These non-invasive treatments help restore tear film stability and alleviate dry eye symptoms effectively. If you’re experiencing dry eyes or just want to check it out, it’s worth the visit.