Who Is Affected by Blepharitis?

Granulated eyelids is a common condition that affects the eyelids. Often referred to as blepharitis, granulated eye lids is a common problem in both adults and children. Blepharitis is an inflammation and sometimes an infection of the eyelids and lashes. It is the most common complication of ocular rosacea. The extent to which the blepharitis affects some people depends on the type of blepharitis. Blepharitis can be considered anterior blepharitis, affecting the outside of the eyelid and eyelashes or posterior blepharitis, affecting the meibomian or oil glands of the eyelid.

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Anterior Blepharitis

Anterior blepharitis can be caused by poor hygiene. When the bacterial load begins to grow, it can collect in the crevices and folds on our eyelids. If our hygiene is poor, the bacteria grow more, causing inflammation, redness and flaky or crusty discharge. Blepharitis associated with poor hygiene is more common children and teens. Seborrheic dermatitis, acne rosacea and allergic reactions to chemicals are also causes of blepharitis. Another important cause is demodex. Demodex is an eyelash mite that infests the eyelid margins and eyelashes. As we get older, demodex tends to hang around a little longer and proliferates.

When blepharitis becomes more chronic, the eyelids become red, thicker and roughened in appearance and thus, more granulated in appearance. Although, this can occur in children, it is more common in elderly patients and patients who have ocular rosacea.

Posterior Blepharitis

Posterior blepharitis refers to meibomian gland dysfunction. The eyelids are lined with meibomian glands. These glands secret a type of oil that contributes to the stability and quality of your tears. Without the oily layer of the tears, your tears will evaporate quickly. When people have this problem, they have evaporative dry eye syndrome. People who have meibomian gland dysfunction can also develop granulated eye lids. Their eyelids typically appear thickened, swollen and usually have a red rimmed appearance. They also developed oily, waxy meibomian caps along their eyelid margin.

Risk Factors for Blepharitis

Blepharitis is one of the most common eye conditions. More than 40% of those visiting an eye care provider have symptoms of blepharitis.

You may be at risk for developing blepharitis if you have:

• Dandruff
• Dry eyes
• Oily skin
• Meibomianitis, a disorder of the oil glands in your eyelids

You are also at greater risk of developing this condition if you don't keep your eyelids clean.

Treating Blepharitis

Treatment of granulated eyelids encompasses many different remedies. The most common way of reducing the signs and symptoms is to apply very warm compresses to the eyelids. Not only does it bring comfort to the patient suffering from blepharitis, it also brings blood flow to the area to speed healing and can physically "melt" the hardened or impacted eyelids glands. Warm compresses also generally reduce itchiness and pain. 

Many healthcare providers prescribe steroid eye drops to relieve blepharitis symptoms such as redness and irritation. Your healthcare provider may also recommend over-the-counter eye drops called artificial tears or eyelid scrubs.

Antibiotic ointments can also help blepharitis. These include:

• Ocu-Tracin (bacitracin ophthalmic)
• Eyemycin (erythromycin ophthalmic)

Antiparasitic eye drops can also help demodex blepharitis. These include:

• Xdemvy (lotilaner ophthalmic solution)

In certain cases when the condition can be stubborn, oral antibiotics pills are prescribed anywhere from 7 days up to several months.

Preventing Blepharitis

You may not be able to stop blepharitis from coming back. The condition is often chronic and requires daily management.

Depending on the cause, blepharitis flare-ups may last up to a few weeks. Certain lifestyle choices can make blepharitis worse, such as:

• Touching your eyes
• Using old makeup, which may contain bacteria
• Not removing makeup before bedtime
• Using eye makeup behind your lashes

You may be able to prevent flare-ups and manage symptoms by keeping your eyelids clean with a gentle cleanser.

A Word From Verywell

Some people who suffer from granulated eyelids may also develop a stye, also referred to as hordeolum from time to time. A stye can be confused with a chalazion, which is a blocked gland in the eyelid. These are not infected and are usually not painful, although they are treated the same as a stye with warm compresses. An internal stye arises from the gland of Zeis or Moll, while an external stye comes from an infected meibomian gland.