Blepharitis medications & treatments
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Blepharitis is a common eye disorder that affects an estimated 25 million people in the United States. It is the most common cause of dry eyes. It can affect people of any age, ethnicity, or gender but is more common in people over the age of 50. While most forms of blepharitis affect people equally, 80% of cases caused by a staphylococcal infection affect women.
What is blepharitis?
Blepharitis is a common eye condition characterized by an inflammation of the eyelids. It usually affects both eyes along the edges of the eyelids. Blepharitis can cause your eyelids to become red, swollen, and itchy. It can also cause crusting and dandruff on your eyelids and eyelashes. Blepharitis can be uncomfortable but it’s not contagious and doesn’t usually cause permanent damage to your eyesight.
Blepharitis can be an acute (short-term) or chronic (long-term) condition. Acute blepharitis is typically caused by infections or allergies. Chronic blepharitis is usually classified by its location on your lids. The 2 types include:
- Anterior blepharitis. This type occurs on the front of your eyelid, where your eyelashes are located. It is usually caused by a bacterial infection or a build-up of oily secretions associated with skin conditions like rosacea.
- Posterior blepharitis. Meibomian gland dysfunction typically causes posterior blepharitis. It is located on the inner edge of your eyelids, closest to your eye.
Causes of blepharitis
The exact cause of blepharitis is not known, but you may be at an increased risk if you have the following:
- Dandruff on your face or scalp (seborrheic dermatitis)
- Blocked oil glands in your eyelids
- Dry eyes
- Skin conditions such as rosacea and eczema
- Oily skin
- Demodex mites or lice
How is blepharitis diagnosed?
To properly diagnose blepharitis, your family doctor or eye care specialist (ophthalmologist or optometrist) will look at your symptoms, perform an eye exam, and may run some tests.
Common symptoms of blepharitis include:
- Red eyes
- Itchy eyes
- Feeling like something is in your eye
- Watery eyes
- Dry eyes
- Burning or stinging in your eyes
- Sensitivity to light
- Blurred vision
- Crust on your eyelashes when you wake up
- Damage to other parts of your eye, like the cornea
In addition to asking about your symptoms, your doctor will closely examine your eyes for signs of blepharitis. Some other procedures they may try include:
- Slit lamp. A slit lamp is used to help diagnose what type of blepharitis you have. It is a low-power microscope with a bright thin-beam light used to examine various parts of your eyelids and eye. It can find foreign bodies in your eye or other swelling or damage that may be causing your condition.
- Skin swab. Your doctor may also take a swab of the oil or crust from your eyelid to determine if there are signs of an infection or allergy.
What are some blepharitis treatment options?
While there is no cure for blepharitis, eyelid hygiene is the best way to treat and manage this condition. For more severe cases, your doctor may prescribe some medications to treat the underlying cause.
- Warm compresses. Use these daily to help soften the crust and loosen oily debris. Wet a clean washcloth with warm water. Wring out the excess water and place it over your closed eye for a few minutes.
- Wash your eyelids. Use a cotton swab dipped in a diluted mixture of baby shampoo and water or an over-the-counter eyelid wash to clean your eyelid margins and the base of your eyelashes. This should be done at least twice a day.
- Avoid eye makeup. If you have symptoms of blepharitis, you should avoid wearing eye makeup.
- Eye lubricants. Blepharitis is often a cause of dry eyes. Using artificial tears throughout the day can help relieve this symptom.
- Antibiotics. Antibiotic eye drops such as Polytrim (polymyxin B and trimethoprim) or antibiotic ointments such as Ilotycin (erythromycin) are used to treat bacterial infections that could be causing your blepharitis. In more severe cases of blepharitis, oral antibiotics are used.
- Steroids. Your eye doctor may add a steroid eye drop to help reduce inflammation. Medications such as Pred Forte (prednisolone) can be used alone or in addition to an antibiotic.
- Immunosuppressants. Adding an immunomodulator, such as Restasis (cyclosporine) and Restasis Multidose (cyclosporine), blocks your body’s immune response to reduce inflammation.
What is the best medication for blepharitis?
The best medication for the treatment of blepharitis will depend on the individual’s specific medical blepharitis, medical history, medications that the individual is already taking that may potentially interact with blepharitis medications, and the individual’s potential response to the treatment. It is advisable to always speak with your healthcare provider about the best medication for you. The table below includes a list of the most prescribed or over-the-counter blepharitis medications approved by the Food and Drug Administration (FDA).
Best medications for blepharitis
|Drug name||Drug class||Administration route||Standard dosage||Common side effects
|Lotemax (loteprednol)||Corticosteroid||Eye drop||Apply 1 to 2 drops into the conjunctival sac of the affected eye(s) 4 times daily.||Blurred vision, burning, tearing, dry eyes, itchy eyes, foreign body sensation
|Pred Forte (prednisolone)||Corticosteroid||Eye drop||Instill 1 to 2 drops in the affected eye(s) 2 to 4 times daily.||Eye pain, corneal ulcers, pink eye, drooping eyelid
|Maxidex (dexamethasone)||Corticosteroid||Eye drop||Apply 1 to 2 drops into the conjunctival sac of the affected eye(s) every 4 to 6 hours.||Cataracts, increased eye pressure, burning, stinging, discharge, blurred vision
|Ilotycin (erythromycin)||Antibiotic||Eye ointment||Apply ½ inch every 4 to 12 hours, depending on the severity of the infection.||Redness, allergic reactions, burning, blurred vision
|AzaSite (azithromycin)||Antibiotic||Eye drop||Apply 1 drop to the affected eye(s) twice daily for 2 days, then apply 1 drop daily for 5 days.||Eye irritation, allergic reaction, dry eye, rash, runny nose
|Bacitracin||Antibiotic||Eye ointment||Apply ¼ to ½ inch ribbon every 3 to 4 hours or every 8 to 12 hours for 7 to 10 days.||Blurred vision, eye irritation, burning, stinging, itching
|Polytrim (trimethoprim/polymyxin B)||Antibiotic||Eye drop||Instill 1 drop into the affected eye(s) every 3 hours for 7 to 10 days. Max of 6 doses per day.||Eye pain, redness, burning, stinging, itching, swelling
|Polysporin (polymyxin B/bacitracin)||Antibiotic||Eye ointment||Apply ½ inch ribbon to conjunctival sac every 3 to 4 hours for 7 to 10 days.||Eye irritation, redness, swelling, itching, burning
|Neosporin Ophthalmic (neomycin/polymyxin B/gramicidin)||Antibiotic||Eye drop||Instill 1 to 2 drops into the affected eye(s) every 4 to 6 hours for 7 to 10 days.||Eye irritation, redness, swelling, itching, burning
|Tobradex (dexamethasone/tobramycin)||Antibiotic/corticosteroid||Eye drop||Instill 1 to 2 drops into the affected eye(s) every 4 to 6 hours.||Itchy eyes, swelling, redness, elevated eye pressure
|Maxitrol (dexamethasone/neomycin/polymyxin)||Antibiotic/corticosteroid||Eye drop||Instill 1 to 2 drops into the affected eye(s) every 4 to 6 hours.||Blurred vision, stinging, eye pain, rash, headache
|Blephamide (prednisolone/sulfacetamide)||Antibiotic/corticosteroid||Eye drop||Instill 2 drops into the affected eye(s) every 4 hours during the day and at bedtime.||Eye pain, swelling, redness, itching, discharge
|Zylet (tobramycin/loteprednol)||Antibiotic/corticosteroid||Eye drop||Instill 1 to 2 drops into the affected eye(s) every 4 to 6 hours.||Eye pain, swelling, redness, itching, discharge
|Restasis (cyclosporine)||Immunosuppressant||Eye drop||Instill 1 drop in each eye twice daily (12 hours apart).||Eye pain, tearing, discharge, stinging, blurred vision, foreign body sensation
Your healthcare provider will determine the right dosage based on your response to the treatment, medical condition, weight, and age. Other possible side effects may exist; this is not a complete list.
What are the most common side effects of blepharitis medications?
As with all medicines, those used for blepharitis will have some side effects, depending on the class you are taking. The most common side effects of medications used to treat blepharitis include:
- Eye pain
- Blurred vision
- Foreign body sensation
- Increased eye pressure
What are some home remedies for blepharitis?
Many cases of blepharitis can be treated at home with some self-care measures.
Eyelid hygiene can be used to manage and treat your symptoms of blepharitis. These self-care measures include:
- Warm compresses twice a day to loosen the crust and oily debris from your eyelids.
- Wash your eyelids with diluted baby shampoo following a warm compress. You should gently scrub the base of your eyelashes for about 15 seconds.
- Massaging the eyelid and eyelid margins using small circular motions will help push out oil backed up in the glands.
Frequently asked questions about blepharitis
Is blepharitis contagious?
No, although some cases are caused by infections, it is not contagious.
What are some complications of blepharitis?
If left untreated, blepharitis can cause you to lose your eyelashes, corneal damage, styes, chalazion (hard, painless lump on your eyelid), dry eyes, and chronic conjunctivitis (pink eye).
What should I avoid while having symptoms of blepharitis?
You should avoid wearing contact lenses and using eye makeup if you are having a flare-up of blepharitis.
When should I see a doctor for blepharitis?
Most cases will go away with good eyelid hygiene. If your symptoms worsen or do not improve in a few days, despite good hygiene practices, you should schedule a visit to see your doctor.
Related resources for blepharitis
The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.