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What Is Blepharitis, and What Can You Do About It?

As a dry-eye expert, John A. Moran Eye Center optometrist Deepika Bagga, OD, has decades of experience caring for patients with blepharitis.

Blepharitis is an annoying, chronic inflammation of the eyelid margins that can cause red eyes, swollen eyelids, eye pain, itching, irritation, and blurry vision. It can also cause crusty, dandruff-like flakes on the eyelashes. Although blepharitis may also cause dry eye symptoms, it’s a separate disease requiring careful diagnosis and management.

Bagga explains the latest approaches to managing blepharitis, including prescription medications, at-home remedies—and even the Mediterranean diet.

What causes blepharitis?

We all have bacteria, viruses, allergens, and parasites in the natural flora of our eyes. Some people have more organisms residing at the base of their eyelid margins and eyelashes, and this is where those dandruff-like flakes can form. Blepharitis can also result from excessive oil produced by glands in the eyelids.

Blepharitis isn’t associated with any particular patient demographic, but there is evidence suggesting it's linked to hormonal changes in women, diabetes, oral contraceptives or antidepressants, and several autoimmune disorders, including ocular rosacea or Sjogren’s syndrome. Other causes include poor eyelid hygiene, bacterial infections, or allergic reactions.

Blepharitis can begin at any age and gets worse with aging, so it’s important to identify and treat it.

How is blepharitis treated?

We can usually control early-stage blepharitis with artificial tears and drugs that restore the balance of the eye’s tear layer. These drugs are remarkably effective and have improved significantly in the past decade.

I tell my patients not to underestimate the relief that comes from applying regular warm compress to the eyes at home. But there is no one-time fix, and it is important to continue treatment for life.

Can diet help?

I’m passionate about the Mediterranean diet, a way of eating that emphasizes a variety of plant-based foods, fish, nuts, and whole grains and keeps saturated fats to a minimum. This style of eating lowers inflammation throughout the body and has also been shown to minimize or help reduce the risk of developing age-related macular degeneration and other medical conditions.

Healthy eating can supplement any medication. I think of food as medicine and recommend that my patients eat something like 9-12 types of fruits and vegetables daily and enjoy the benefits of omega-three fatty acids found in fish and vitamins A and B from eggs. I also recommend limiting your daily intake of red meat. Vegetarians may want to incorporate super-nutrient foods such as chia and flax seeds into their diets.

Who can treat blepharitis?

If patients have excessive tearing, itching, or burning of their eyes, they should see an optometrist and ophthalmologist for a comprehensive eye exam to evaluate for blepharitis and to determine the best course of treatment.