Diagnosis and treatment

Treatment for blepharitis

Blepharitis is usually a long-term (chronic) condition, which means once it develops it can cause repeated episodes. 

There is no cure for blepharitis, but establishing a daily eyelid-cleaning routine can help control the symptoms and any dryness can be treated with artificial tear drops. Lid cleaning often needs to be continued indefinitely to prevent recurrence.

More severe cases of blepharitis may require treatment with antibiotic ointment applied to the eyelids or, antibiotic drops for the eyes and, in a few cases, steroid eye drops.

Some patients benefit from antibiotics by mouth, particularly when the blepharitis is associated with a skin condition such as rosacea. These antibiotics are usually required for at least four to six weeks and may need to be continued for many months.

Lid hygiene

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.

video transcript

Welcome to this short video on lid hygiene techniques which are useful for people with eyelid and tearful disorders both the upper and lower lids contain many oil glands called my Burnie of glands your doctor may advise lid hygiene if these glands become blocked leading to dry eye and inflammation.

First stage of lid hygiene is to soften the oils in the glands using heat with a warm compress one way to do this is to heat a flannel under the hot tap wring it dry and make sure it's not too hot to touch

With this warm flannel hold it over the eyes which are closed for at least three minutes. Alternatively you can warm a microwavable eye back bought from your local pharmacy according to the manufacturer's instructions. Use this eye bag in a similar fashion to the panel and hold it over the closed eyes for a minimum of three minutes.

The next stage unblocks the warmed oil glands using piloted compression. One technique is to express the oils by compressing your eyelid using the rolling motion of your finger. This aims to move the softened oils out of the glands and onto the surface of the eye. Another way to achieve this is to use your index finger and thumb to squeeze the glands in the eyelid. This will allow that softened oil to
come out of those blocked glands.

A useful tip is to look in the opposite direction to the eyelid that you are
currently pressing. The final stage wipes away any bacteria and excess oils from your lid margin the aim is to clean both the front and the back of the eyelid margin moisten a cotton bud and using this rub along the front of the eyelid margin and then followed by the back of the eyelid margin

An alternative is to use a pre-prepared wipe available from your local pharmacy clean the eyelid margin in a similar fashion to when using the cotton bud your doctor may prescribe you some eyedrops in addition to advising to do that hygiene pull down your lower eyelid and look upwards when administering your eyedrops.

Step by step guide: lid hygiene techniques in 3 steps

Please ensure any contact lenses are removed first. 

Step 1: Soften oils with hot compress

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.

Step 2: Unblock oil glands with massage

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.

  • Use your index finger to apply pressure to the eyelid whilst slowly rolling it towards the eyelashes.


  • For the upper lid, look downwards and either pinch the eyelid between your forefinger and thumb applying pressure between them, or press with your forefinger against the white of the eye. Perform the opposite for the lower lid.

Step 3: Clean edges of eyelids

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.

Possible complications

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 above.

Less commonly, blepharitis can lead to changes on the clear window of the front of the eye (cornea). This will usually require further treatment.

Blepharitis treatment is available at Moorfields Private

You can self-fund or use private medical insurance to fund your treatment.

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