Blepharitis is a common condition that causes inflammation (irritation) of the eyelids, leading to red rimmed, sore eyes, sometimes with crusting at the roots of the eyelashes. It is extremely common, responds well to simple treatment and, for most people, it is not harmful. Symptoms include red and sore eyelids, tiny flake like dandruff at the bottom of the eyelashes, dry or burning eyes and sometimes blurring of the vision. You might also have the feeling that there is something in your eye.
There is no direct cause of blepharitis but it is more common in people who have skin conditions such as eczema and acne, and in those with allergic diseases like asthma. Eyelids contain tiny glands that make an oil which keeps the eyes moist as part of the tear film.
In Blepharitis, these glands become blocked, which causes irritated eyelids and dry, soreeyes. It is thought that in some people, blepharitis is partly caused by sensitivity to the bacteria (staphylococcus) which normally live on the skin.
There is no cure for blepharitis but symptoms can be managed. The most important treatment is good eye care, known as “lid hygiene” and this should be done twice daily with clean hands. This includes even when the symptoms are not there, to reduce the severity and frequency of the symptoms.
The aim of lid hygiene treatment is to encourage healthy tears to lubricate the eye and reduce inflammation. This is achieved by softening the oils in the eyelid glands, unblocking the glands and removing any flakes or excess bacteria.
Below is a step by step guide of how to perform these techniques effectively.
Please ensure any contact lenses are removed first.
Hold a hot flannel or microwavable eye bag firmly onto closed eyelids for 3 minutes to soften the oil in the glands. Take care not to burn your skin
This should always be done immediately after step 1. The aim is to apply pressure to the eyelids to clear the softened oil out of the glands, ready to be cleaned away.
Or
Moisten a cotton bud with tap water, or use commercially available eyelid wipes to clean the edges of the eyelids gently but firmly, both where the eyelashes come out of the skin and behind the eyelashes.
To clean behind the lashes, you will need to pull the eyelid away from the eye with your finger. This aims to remove any flakes or crusting from the base of the eyelashes, as well as cleaning away excess oils and bacteria.
Your doctors, optician or pharmacist may advise you on other types of treatment available.
The treatments listed below should only be used as recommended and are not covered in this leaflet:
Blockage of the oil glands can lead to a meibomian cyst or chalazion, which leaves a round painless swelling in the eyelid. The blocked gland can get infected and become red and sore. To help treat the cyst, use the warm compress treatment as per steps 1and 2 in this leaflet as early as possible.
Less commonly, blepharitis can lead to changes on the clear window of the front of the eye (cornea). This will usually require further treatment.
Please seek advice if your eye becomes increasingly red or painful, your sight becomes more blurred or you develop very noticeable and spreading redness together with a lot of eyelid swelling.
Review date: June 2026