Eyelid Margin Disease Types and Treatment

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Eyelid margin disease, also referred to as blepharitis, is a common condition in which the eyelid margins are persistently inflamed. You can experience itching, stinging, burning, redness, and dandruff-like flakes on the eyelashes and eyelid margins with this condition.

Blepharitis is an uncomfortable condition that usually produces inflamed and itchy eyelids, but it doesn't permanently damage eyesight. Eyelid margin disease can begin during childhood and may last throughout life—or it can begin during adulthood. The best way to manage the condition is with good eyelid hygiene, including regularly cleaning the lids and lashes.

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Blepharitis example. Raimo Suhonen / DermNet / CC BY-NC-ND


The eyelids play an important role in eye health. They protect the cornea and spread tears over the front of the eyes. Eyelid margin disease can affect different parts of the eyelid, and the location is usually dependent on the cause.

Anterior Blepharitis

Bacteria is often present on our skin, and it can proliferate on the eyelid, lashes, and eyebrows, contributing to eyelid margin disease. However, eyelid margin disease is not a bacterial infection—this bacteria is colonization (the presence of bacteria) and not infection (being sick from bacteria).

Anterior blepharitis can also be caused by a mite called Demodex. Demodex is very common and it can be present in greater numbers on our skin as we get older. Demodex infestation is present in 84% of the population at age 60, and 100% of those older than 70. So the older you are, the higher the chance you may have more Demodex.

Although Demodex can be present in higher amounts in people who do not practice good hygiene, it doesn’t necessarily mean you are doing an inadequate job with your personal hygiene.

Posterior Blepharitis

The meibomian glands inside the eyelid have an opening on the eyelid margin, and they normally contribute oils to the tears that protect your eyes. Typically, posterior blepharitis develops due to meibomian gland dysfunction, which is dysregulation or irregular oil production in the glands of the eyelids (meibomian blepharitis). The oil can create a favorable environment for bacterial growth.

Meibomian gland dysfunction is very common, and mild cases often go undiagnosed. Full, complete blinks are important to meibomian gland secretion. Decreased blink rates can contribute to blepharitis by decreasing the excretion of meibomian gland content. Additionally, when the eye remains open and exposed for longer, increased evaporation of tears can contribute to eyelid margin disease.

Meibomian gland dysfunction also causes evaporative dry eye syndrome. The consistency and quantity of the tears can also be examined to identify this problem. With evaporative dry eye, the tears may seem thick or frothy.

When meibomian gland dysfunction is chronic, the glands may clog, and sometimes the glands will actually atrophy.


Blepharitis treatment varies depending on the cause, duration, and other systemic medical problems a person may have.

Full blinks and artificial tears are important for managing dry eye if it develops with blepharitis.

The mainstay of blepharitis treatment is to apply warm compresses several times a day followed by eyelid scrubs once or twice per day. Eyelid scrubs can be as simple as applying lathered baby shampoo onto a warm washcloth. The eye is closed and scrubbed with the washcloth using a gentle back and forth motion. Baby shampoo is recommended because it does not sting your eyes.

Many eye doctors also prescribe topical antibiotics and antibiotic/steroid combination drops and ointments for the eye and eyelid. However, blepharitis is not infectious—the oral antibiotics used to treat the condition decrease ocular flora burden (bacteria), helping to reduce inflammation and clogged glands. Additionally, the antibiotics may have an anti-inflammatory effect.

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  • American Academy of Ophthalmology,Eyelid Margin Disease. Medem, 2004.