Blepharitis: a practical guide to managing eyelid inflammation

Understanding blepharitis

Blepharitis is inflammation of the eyelids, usually affecting the edges of the lids where the eyelashes grow. It often occurs because the tiny oil-producing glands in the eyelids (called meibomian glands) become blocked or irritated. These glands are important because they produce oils that keep the eyes lubricated and prevent tears from evaporating too quickly.

Common symptoms include red or irritated eyelids, crusting or flakes along the lashes, burning or gritty sensations, itching, watery or dry-feeling eyes, blurred vision that improves with blinking, and recurrent styes or chalazia. Symptoms are often worse in the morning and may be triggered or worsened by screen use, contact lenses, makeup, or poor eyelid hygiene.

Blepharitis is closely linked with conditions such as dry eye disease and chalazion (a firm eyelid lump caused by a blocked gland). It is not usually sight-threatening, but it can significantly affect comfort and quality of life if not managed properly.

Blepharitis management

Daily eyelid care is the cornerstone of blepharitis management. The meibomian glands run vertically to the eyelid margins and when their oily secretions thicken and can’t easily flow up and out of them properly, this can lead to irritation and inflammation. Medications can help during flare-ups, but long-term symptoms control depends on consistent eyelid care to soften the oil, help clear the glands, and keep the eyelid margins clean at home.

Eyelid care at home

Eyelid care is based on three simple but essential steps: heat, massage, and wipe. A good routine should be effective, gentle, and realistic enough to stick to - think of it like brushing your teeth, a daily habit rather than a short-term treatment.

1. Heat

Applying gentle heat to the eyelids softens the thick oil in the glands, making it easier to flow. This can be done using a warm compress, a heated eye mask, or a clean cloth, for example muslin cloth, soaked in comfortably warm water. Other options include microwavable eye bags or other tools to maintain a consistent warm temperature. The best method is the one you’ll use consistently. Keep your eyelids closed and apply heat for about 3 minutes, reheating as needed to maintain warmth. 

2. Massage

Once the eyelids are warm, gently massage them to help the oil flow out of the glands toward the eyelid margin. Use a rolling motion with your fingers rather than rubbing across the lid, similar to squeezing toothpaste from a tube. This avoids stretching or irritating the skin, which can make the eyelids sore and discourage regular care.

3. Wipe

Finally, wipe away the released oil and debris to prevent it from flowing back into the glands. A soft cloth dampened with warm water works well.

Baby shampoo, bicarbonate solutions, or medicated wipes may irritate some people and are not always necessary. If additional products such as tea tree oil wipes are used, they are best applied after eyelid cleaning - and only if tolerated.

It can help to start by doing the wiping in front of a mirror until you feel confident; look down when cleaning the lower eyelid to avoid scratching the cornea.

For those who exercise regularly, the eyelid care routine can be easily incorporated into a gym or sauna session. The warmth and mist in a steam room or sauna naturally provide the heat step, and while relaxing with closed eyes, you can gently massage the eyelids to help release the oil. This makes the routine quick, discreet, and easy to fit into your day.

Lifestyle measures

In addition to daily eyelid care, certain lifestyle habits can help manage blepharitis and support eye comfort. Try to take regular breaks from screens and remember to blink frequently, which helps keep the eyes moist. Always remove eye makeup thoroughly to prevent debris from clogging the eyelid glands. Some people may also benefit from adding omega-3 fatty acids - for example, from flaxseed or fish oil - to their diet, as these can support tear quality and overall eyelid health.

When to see a specialist

You should consider seeing an optometrist or ophthalmologist if:

• Symptoms do not improve despite consistent eyelid hygiene
• You develop frequent or painful chalazia or styes
• Your vision becomes persistently blurred
• You experience significant redness, pain, or light sensitivity
• You are unsure whether your symptoms are blepharitis or another eye condition

A specialist can confirm the diagnosis, check for related conditions such as dry eye or rosacea, and prescribe medical treatments if needed, including antibiotic or anti-inflammatory therapies.