What is Blepharitis?

Blepharitis is a common eye condition characterised by inflammation of the eyelids. Symptoms can include redness, itching, crusting near the eyelashes, burning and dryness or, can be present with no symptoms at all. Its presence can affect people of all ages and affects not only the health of the eyelid but the eye itself.

Blepharitis is broadly categorised into two types based on the part of the eyelid affected: anterior blepharitis and posterior blepharitis (also known as MGD- Meibomian Gland Dysfunction) . While these sub-types usually co-exist, they have distinct characteristics, symptoms and treatments which we look into further detail below.

Anterior Blepharitis

Main Symptoms: crusting, redness of lid margins, itching. Usually worse in the morning.

Causes:

Bacterial Infections:
Staphylococcus bacteria are the most common cause, leading to infection of the eyelash follicles, resulting in crusting and irritation.
Seborrheic Dermatitis:
A skin condition causing flaky, greasy patches on the eyelid skin. It can result in irritation and inflammation at the eyelid margins.
Allergic Reactions
Allergies to environmental factors, contact lenses, or cosmetics can trigger inflammation in the eyelids.
Parasites
Demodex mites, which naturally inhabit hair follicles, can overpopulate and contribute to blepharitis, leading to increased irritation and inflammation.
Environmental Factors
Exposure to smoke, pollutants, or dry environments can irritate the eyelid, contributing to inflammation.

Connection with Posterior Blepharitis (a.k.a. MGD)

While anterior blepharitis affects the outer eyelid, it can be connected to posterior blepharitis (MGD), which affects the deeper layers and glands within the eyelids in a few ways:

Bacterial Spread: The bacteria involved in anterior blepharitis, especially Staphylococcus, can sometimes spread to the inner part of the eyelid, affecting the Meibomian glands and leading to MGD.
Inflammatory Cascade: Inflammation from anterior blepharitis can extend into the deeper layers of the eyelid, which may impair the function of the Meibomian glands, contributing to MGD and dry eye symptoms.

This connection is critical because Meibomian gland dysfunction directly affects the tear film stability, resulting in dry eye symptoms such as burning, grittiness and red eyes.

In summary, anterior blepharitis is a problematic condition that on its own, however it can influence the posterior portion of the eyelid, where meibomian glands are located. Therefore at Dry Eye Wales we always encourage ensuring the lids are free of anterior blepharitis before delving deeper into MGD treatments to ensure the best possible treatment outcomes.

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What is Blepharitis?