Medicines for Blepharitis

For most people, blepharitis is controlled without any medicine at all — daily lid hygiene with warm compresses, gentle massage and cleaning of the lash margins is the foundation of treatment and manages the great majority of cases. Lubricating eye drops are often added to ease the gritty, dry feeling. When the lids stay inflamed despite good hygiene, or there is a clearly bacterial, crusted anterior blepharitis, a topical antibiotic ointment may be used for a course. For severe or stubborn disease, particularly when it is linked to rosacea, an eye specialist may prescribe a course of an oral tetracycline antibiotic, used for its effect on the oil glands and inflammation. Even when medicines are used, lid hygiene continues alongside them, because it is what keeps the condition under control long term.

Blepharitis is usually a long-term tendency that is controlled rather than cured. It tends to flare up and settle over months or years, and the aim of treatment is to keep it comfortable and quiet rather than to make it disappear for good. The good news is that for most people, consistent daily lid hygiene keeps the symptoms well under control. Flare-ups are normal, and they do not mean the treatment has failed — they are a cue to step the lid-care routine back up. Because the underlying tendency remains, most people get the best results by continuing some lid care even when the eyes feel fine, rather than stopping the moment things improve.

A simple daily routine has three steps. First, apply warmth to the closed eyelids — a clean warm compress or a reusable heated eye-bag for a few minutes — to soften the oils and crusts. Next, gently massage the lids towards the lashes to help the little oil glands empty. Finally, clean along the lash margins to remove debris, using cotton wool or a lid wipe with cooled boiled water or a cleanser your optometrist or pharmacist recommends. Be gentle and avoid scrubbing hard. Doing this once or twice a day during a flare, and keeping up a lighter version when the eyes are settled, is what keeps blepharitis under control. An optometrist or pharmacist can show you the technique.

Yes. Blepharitis is closely linked to problems with the oil-producing glands in the eyelids, and to certain skin conditions — in particular rosacea, which affects the face, and seborrhoeic dermatitis, the dandruff-type skin condition. People with those conditions are more likely to get blepharitis, and treating the skin condition often helps the eyelids settle too. Blepharitis also overlaps a great deal with dry eye, because inflamed oil glands disturb the tear film; the gritty, dry sensation is common to both and they frequently occur together, which is why lubricating drops are often used alongside lid hygiene. Recurrent styes and cysts on the lid are also more common in people with blepharitis.