written by Dr. William McSwain


Blepharitis is a term that describes inflammation of the oil glands in your eyelids. These oil glands produce an important component of the tear film that lubricates the surface of your eye keeping your vision clear and your eyes comfortable. In blepharitis, the oil glands become blocked by inflammatory material or become infected. The frequency of blepharitis increases with aging and is more common in patients with rosacea. Common symptoms include eyelid redness or soreness, dry eye, burning, a foreign body or “gritty” sensation, and discharge that causes the eyelids to stick together on waking in the morning. Occasionally, a blocked gland may swell in size resulting in a chalazion or become infected by bacteria resulting in a hordeolum or stye.


  • Warm compresses: Take a wash cloth and run it under warm water. Press the wash cloth against your eyelids for at least 5 minutes 2-4 x daily. You will have to reheat the wash cloth during this time if it cools off. The heat and moisture will open up the oil glands in your eyelids. You can also gently massage the oil glands during this time to clear any blockages.
  • Lid scrubs: After doing warm compresses, gently scrub any debris out of your eyelashes for 30 seconds. I recommend using Ocusoft Lid Scrubs or Occusoft Lid Cleanser. Alternatively, you can use Johnson’s Baby Shampoo diluted in water.
  • Avenova is an over-the-counter antimicrobial spray that can improve blepharitis by reducing the amount of bacteria living on the ocular surface. It can be sprayed directly onto closed eyelids or sprayed onto a cotton ball and wiped on your eyelids 2 x daily.
  • Omega-3 fatty acids can improve the function of the oil glands in your eyelids. Consider taking a fish oil or flax seed supplement.
  • Combination antibiotic and steroid medications may improve blepharitis by killing bacteria and decreasing inflammation but require a prescription. I usually prescribe either Maxitrol, Tobradex, or Blephamide ophthalmic drops or ointment. Drops are usually used 2-3 x daily and ointment is used at bedtime. They are usually not used long-term for because they can cause other problems in the eyes such as glaucoma or cataracts.
  • Doxycycline is an oral antibiotic that changes the consistency of the oil produced by the glands in your eyelids. This makes them less likely to become blocked and inflamed. It is particularly effective for rosacea. Side effects of doxycycline include but are not limited to photosensitivity (you may sunburn more easily so avoid the beach), gastrointestinal distress, and vivid dreams. It should not be taken by children under the age of 8, women who are pregnant or breastfeeding, if you have liver disease, or if you take medications like warfarin (Coumadin) or oral contraceptives.