You don't always need antibiotics for blepharitis, as basic eyelid hygiene (warm compresses, cleaning) helps many cases, but antibiotics (drops, ointments, or pills) are prescribed for more severe, stubborn cases, often targeting bacterial overgrowth or underlying skin conditions like rosacea to reduce inflammation and infection. It depends on the cause and severity, with a doctor determining the best treatment.
If blepharitis has caused other problems, such as a lump of fluid under the skin (cyst), antibiotic eyedrops or tablets may be recommended. If your blepharitis is severe, or if you also have other eye symptoms, the GP may refer you to an eye specialist (ophthalmologist).
Treating blepharitis in children focuses on eyelid hygiene: warm compresses (5-10 mins) to loosen crusts, followed by gentle scrubbing of the lash base with diluted baby shampoo or specific eyelid wipes, and rinsing. Massaging eyelids helps unblock oil glands. For persistent cases or infections, doctors might prescribe antibiotic ointments, drops, or oral antibiotics, plus artificial tears or treatments for underlying conditions like dandruff, but the core treatment is consistent cleaning.
Self care
Anterior blepharitis is commonly caused by bacteria (staphylococcus) or oily build-up (seborrhea) associated with skin conditions like rosacea. Posterior blepharitis can worsen dry eye and lead to painful eyelid styes.
There is no cure. However, there are a range of treatments that have proved successful in controlling the symptoms. The most important one is to establish a daily eye cleaning routine. More severe cases of blepharitis may require the use of antibiotics.
Bacterial Conjunctivitis normally causes a yellow or green sticky discharge throughout the day. They will feel itchy, and the eyelids may become swollen. Viral Conjunctivitis normally causes a watery discharge during the day and present with sticky discharge in the morning. The eyelids may become very swollen.
What causes blepharitis? Most of the time, blepharitis happens because you have too much bacteria on your eyelids at the base of your eyelashes. Having bacteria on your skin is normal, but too much bacteria can cause problems. You can also get blepharitis if the oil glands in your eyelids get clogged or irritated.
Popular OTC brands include Systane®, Refresh®, and TheraTears®. These are often considered the best over-the-counter eye drops for blepharitis because they hydrate the eye and flush away irritants.
Rubbing your eyelids may make the inflammation worse, so try to avoid doing this. As mentioned above, blepharitis commonly develops in people with seborrheic dermatitis, rosacea or dry eye syndrome. If relevant, treatment of these other conditions may also help to ease symptoms of blepharitis.
Blepharitis can be confused with other conditions such as ocular rosacea, episcleritis, herpetic keratitis, or conjunctivitis (pink eye). UT Southwestern ophthalmologists have advanced training and experience in evaluating patients with symptoms of eye conditions to confirm a diagnosis.
Blepharitis is a chronic (long-term) condition. This means that once you have had it, it can come back even after it has cleared up. It normally affects both eyes. You can usually treat it by keeping your eyelids clean.
If you are experiencing symptoms of blepharitis, or meibomian gland dysfunction, schedule an exam with an eye doctor as soon as possible to obtain a proper diagnosis and effective treatment plan.
Complications of Blepharitis
Eyelid skin problems—You can get scarring on your eyelids, or the edges might turn inward or outward. Watery or dry eyes—Abnormal tear film can cause excess tearing or dry eyes and irritation. Stye—A painful lump near the base of the eyelashes.
Conjunctivitis is often caused by infections or allergies, while blepharitis is often a chronic condition linked to bacteria or gland issues. If you are struggling with red, itchy, or watery eyes, don't guess! See an eye care professional for an accurate diagnosis and treatment plan.
Can I get OTC antibiotic eye drops? Infections of the eyes or surrounding skin require a visit to an eye care professional. A physician prescribed antibiotics or other effective and safe products. As such, antibiotic eye drops are generally not available over the counter.
Many medications are available for blepharitis, including antibiotics and steroids (cortisone), in drop or ointment form. While cortisone medications often bring quick relief of symptoms, long-term use can cause some harmful side effects.
There are many possible causes of blepharitis. Effective treatment depends on treating the underlying cause. If the cause is due to an allergy, by eliminating exposure to the allergen and using antihistamine eye drops the symptoms may resolve.
Antibiotics to treat blepharitis
You may get a prescription for an antibiotic ointment — such as erythromycin, bacitracin ophthalmic or Polysporin® for your eyelid — or for antibiotic eye drops, such as a combination of polymyxin B and trimethoprim (Polytrim®).
The Stress-Blepharitis Connection
Studies have shown that psychological stress can trigger inflammation and weaken the immune system, making the body more vulnerable to chronic conditions, including blepharitis.
Blepharitis progresses through stages, generally moving from initial inflammation and mild crusting (Stage 1) to blocked meibomian glands and swelling (Stage 2). Further progression involves increased crusting, lash misdirection, and inflammation (Stage 3), leading to severe dry eye, lash loss, and potential eyelid structural changes like entropion or ectropion in advanced cases (Stage 4).
Optometrists can diagnose and treat various eye infections and conditions. They have an in-depth knowledge of how the eye works and how health conditions can impact your vision. Some of the most common eye infections optometrists can help treat include: Conjunctivitis (pink eye)
The initial symptoms of fungal eye infection often include redness and discomfort in the affected eye. Patients may notice mild to moderate eye pain that can persist or worsen over time. Blurred vision or reduced visual acuity may develop as the infection progresses but can be subtle in early stages.
Mild bacterial pink eye may get better without antibiotic treatment and without causing any complications. It usually clears up in 2 to 5 days without treatment but can take 2 weeks to go away completely.