Guide · blepharitis
Blepharitis: what helps tonight, and what actually fixes it
Blepharitis will not clear overnight. You can make tonight and tomorrow morning a great deal more comfortable, and you can stop it coming back. Here is both.
Tonight: three things that help by morning
Warmth, for ten minutes. A heated eye mask, not a flannel: a flannel cools within about a minute, before the oil has had time to soften. You are softening the oil and the crusting along the lash line, not cooking it, so warm, not hot.
Clean the lid edges, gently. Straight after the warmth, with a lid wipe or a cotton pad and cooled boiled water. Sweep along the base of the lashes, top and bottom, eyes closed. The aim is to lift the crust, not scrub the skin.
A preservative-free lubricating drop before bed, and nothing on the eyes overnight that you have not used before. Take contact lenses out and leave them out until the lids settle.
Why it keeps coming back
Blepharitis is inflammation of the lid edge. Underneath it is usually one of three things: a build-up of bacteria along the lashes, tiny mites called Demodex that live at the lash roots, or oil glands in the lid that have blocked. Often it is a mix. Warmth and wipes calm the surface, and that is why it feels better for a few days. They do not reach the glands or the mites, which is why it returns.
What actually fixes it
Finding out which of the three you have. We look along your lashes under the microscope, check the oil glands, and show you on the screen what we see. Then the lid edges are cleaned properly in the chair, the glands warmed and cleared by hand, and if mites or inflammation are the driver we treat those too. Most people feel the difference after the first visit.
When to be seen the same day
A red, painful eye, a lump on the lid that is getting bigger, or any change in your sight: ring us today. That is not blepharitis to manage at home.
The three types of dry eye, and what we do for each
Most people are told “you’ve got dry eyes” and handed drops. But there are three different causes, and each needs something different. Most people have a mix.
Blocked oil glands: meibomian gland dysfunction (MGD)
In one large study, 86% of people with dry eye had signs of this. Along the edge of your eyelids are tiny glands, about 30 in the top lid and 25 in the bottom, that put a thin layer of oil on your tears. When they block, your tears dry up in seconds, however much water your eyes make. It feels gritty, burning and tired, often worse on screens or by evening. Drops help for an hour, because they don’t unblock the glands.
What we do: photograph your glands so you can see them, warm and clear them in clinic, clean the lid edge, and use IPL or light therapy where it helps. Then we give you a simple routine for home.
Not enough tears
Your eyes don’t make enough of the watery part of tears. This is more common with age, some medicines, the menopause, and conditions like Sjögren’s.
What we do: measure your tear level, choose the right drops for you, and use tiny plugs to keep your own tears in where they help. We’ll write to your GP if something needs checking.
Inflamed eyelids: blepharitis, often with tiny mites called Demodex
Crusty, itchy, red lid edges, often worse in the morning.
What we do: deep-clean the lid edge in clinic, treat the mites, and show you how to keep the lids clean at home.
Not sure which one you have? That’s what the assessment is for. We look at your glands, tears and lids, and tell you which type, or which mix.
The short version
- Tonight: ten minutes of warmth, clean the lid edge, a preservative-free drop
- It returns because wipes do not reach the glands or the mites
- An assessment finds which of the three is driving yours
- Red, painful or sight changing: be seen today