Blepharitis (Chalazion, Hordeolum/Stye)

What is blepharitis?

Blepharitis is an inflammation in the meibomian glands in the eyelids and eyelashes. The meibomian glands are tiny oil glands at the edge of the eyelid that can become clogged and infected. This can lead to inflammation around the gland and eyelashes and causes redness and debris at the edge of the eyelid. There is often burning sensation along with redness of the eyes. In severe cases, blepharitis can damage the cornea (front surface of the eye) leading to light sensitivity and decreased vision. 

What are the types of blepharitis?

  • Anterior blepharitis - The inflammation affects the front side of the eyelid. Dandruff or scaling around the eyelashes is common. 
  • Posterior blepharitis - The inflammation affects the back side of the eyelid. Bumps on the eyelids called chalazion and hordeolum (styes) are common. 
  • Chalazion - A chalazion is a clogged meibomian gland and is a swollen bump on inner surface of the eyelid. Chalazions may increase in size and become tender. 
  • Hordeolum/Stye - a hordeolum or “stye” is a clogged and infected meibomian gland or eyelash causing a red and painful bump on the eyelid. The bump may be on the outside or the inside of the eyelid. 

What are the causes of blepharitis?

Anyone can be affected by blepharitis, chalazions, and hordeolums. People with skin conditions such as acne rosacea or seborrheic dermatitis may be more prone for these eyelid problems.

How is blepharitis diagnosed?

Blepharitis is usually diagnosed following complete eye examination, especially examining the eyelids. 

What is the treatment for blepharitis?

Warm Compresses

Warm compresses help decrease inflammation and in cases of chalazions, hordeolums/styes, help the clogged oil gland to drain. A clean washcloth soaked in hot water can be used for 5-10 minutes at least 2-3 times per day.  Alternatively, a sock filled with rice (tie the end of the sock) or a reheatable eye compress mask can be used. For chalazions and hordeolum/stye, gentle massage around the area can be done to help drain the gland. 

Eyelid Scrubs

Washing and scrubbing the eyelashes and edges of the eyelids can help remove debris and unclog the glands. Diluted baby shampoo can be applied with the fingertip. There are also over the counter eyelid scrubs, some of which have tea tree oil extracts that can be very helpful when symptoms are long-lasting.

Eye Drops or Ointments

Your physician may prescribe eye drops or an ointment that can be applied to the eyelids. 

Oral Medications

In very difficult cases, your physician may prescribe oral medications. This is usually only done when the warm compresses, scrubs and drops/ointments do not adequately control the symptoms.

Surgery

For chalazions and hordeolums/styes that do not go away with warm compresses, eyelid scrubs and drops/ointments, your physician may recommend surgery. In children, this is usually done under general anesthesia in order to keep your child comfortable during the procedure.