How Blepharitis Is Diagnosed

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Blepharitis is a common condition that causes inflammation and irritation of the eyelids. Blepharitis often produces flaky debris at the bases of the eyelashes, causing the eyelids to become inflamed and itchy. Some people complain of feeling like something is in their eyes that won't come out or a burning sensation on the insides of the eyelids. Usually, diagnosis of blepharitis can be made by analyzing a patient's symptoms and complaints, administering a thorough eye examination. Your healthcare provider will check for signs of debris or redness of the eyelids. Occasionally, additional diagnostic tests are performed.

Woman touching eye
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Your healthcare provider will ask you to describe the blepharitis symptoms you are experiencing. You may complain that your eyes are irritated, itchy, or burning at the edges of your eyelids. You may feel a foreign body sensation, as if something is stuck inside of your eyes. You might be noticing crusty scales or granulations stuck to both your upper and lower eyelids, especially first thing in the morning. You may feel as if your eyelids are "glued" shut upon waking.

Your healthcare provider will look for any other health problems that may be contributing to a patient's eye problem. People with blepharitis sometimes have rosacea, a skin condition characterized by redness of the cheeks.

Risks Factors

People with oily skin, dandruff or dry eyes tend to have a tendency to develop blepharitis. Blepharitis is often associated with meibomianitis, a dysfunction of the oil glands of the eyelids. People with poor hygiene habits tend to have an increased risk of developing blepharitis.


A primary care provider can usually make the diagnosis with the history and a careful physical examination. Your healthcare provider will also have the benefit of a more careful eye exam. He or she will probably use a slit lamp during an examination to diagnose blepharitis.

A slit lamp is a microscope with a light attached that allows an healthcare provider to examine your eyelids and eyelashes under high magnification. Your eyelid margins, bases of your eyelashes, oil gland openings, tears, and front surfaces of your eyeballs will be thoroughly examined.

If you have blepharitis, debris and dandruff-like scales may be visible and the eyelid margins may be red and swollen. The added advantage of the slit lamp is that it can help the healthcare provider distinguish between different causes of blepharitis.

The finding of collarettes along the base of the lashes is diagnostic for an entity called demodex blepharitis, which is caused by a mite infestation. The mites can grow within lash follicles of the skin and eyelids, which can cause inflammation and blepharitis.

A comprehensive eye examination is usually enough to reveal a case of blepharitis, without the use of other diagnostic tests. However, your healthcare provider may take a culture of your eye secretions in order to rule out an eye infection. Your practitioner may simply swab the discharge of your eye and send it to a laboratory for further investigation.

Another common diagnostic test is called meibography. This allows for direct imaging and assessment of the health of the oil glands along the eyelid margin.

Furthermore, if you fail to respond to necessary blepharitis treatment, more diagnostic tests may be performed in order to rule out allergies.


Conjunctivitis and keratitis can be complications of blepharitis. Conjunctivitis is an inflammation of the conjunctiva, the delicate membranes that line the eyelids. The conjunctiva covers the white part of the eye. Often called "pink eye," conjunctivitis is a common eye disease. The condition can affect one or both eyes together.

Some types of conjunctivitis are very contagious and are easily spread in schools and at home. Conjunctivitis is usually easy to treat but sometimes develops into a more serious problem.

Another common complication is dry eye syndrome which can actually manifest as excessive reflexive tearing. Additional complications include eyelash loss as well as stye and chalazion formation.


Keeping your eyelids clean and healthy is an important part of treating as well as preventing blepharitis. The goal of eyelid hygiene procedures is to soothe the eyelids, unplug any blocked oil glands and clear out oily secretions from the glands. With proper hygiene measures, the eyelids are thoroughly cleaned and debris is completely removed. You should make eyelid hygiene a part of your daily routine. The routine should consist of applying warmth with a washcloth, massaging gently and cleansing thoroughly.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. Sarac G, Cankaya C, Ozcan KN, Cenk H, Kapicioglu YK. Increased frequency of Demodex blepharitis in rosacea and facial demodicosis patientsJ Cosmet Dermatol. 2020;19(5):1260-1265. doi:10.1111/jocd.13150

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Additional Reading
  • American Optometric Association. "Care of the Patient with Ocular Surface Disorders." Optometric Clinical Practice Guideline, AOA, 1995-2002.

By Troy Bedinghaus, OD
Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.