Blepharitis and MGD

What is Blepharitis?

Blepharitis is a chronic inflammation of the eyelids caused by bacteria on the lid and eyelash base. A build-up of this bacteria can penetrate the lid tissue causing clogged tear glands and lower tear production. This inflammation creates irritation and ultimately lead to Dry Eye Syndrome.

Blepharitis can usually be controlled relatively easily. Initial treatment includes lid hygiene and may also include antibiotic drops or ointment to help control the inflammation. Blepharitis responds quite readily to this treatment but may tend to recur. Recurrence can be kept to a minimum by on-going use of lid hygiene.

The lid margins of the upper and lower lids should be thoroughly cleaned each morning and each evening for two weeks after initial diagnosis. Using a lid scrub process will remove the dry skin and bacteria on the lid margins and will usually subside any redness, swelling or irritation. Lid hygiene should be continued on an ongoing basis 2-3 times each week after the initial treatment period.

This video will help explain the types of blepharitis and how to follow a good hygiene regimen.

Blepharitis Stages

Stage 1 has inflammation of the lid margin with little to no build-up

Stage 2 has inflammation of the lid margin and lash follicles with mild build-up

Stage 3 has inflammation of the lid margin and lash follicles with moderate build-up

Stage 4 has inflammation of the lid margin and lash follicles with a heavy build-up, causing lash misdirection or ingrown hairs

Images are sourced from

What is MGD?

The Meibomian glands secrete oils onto the surface of the eye to help keep the tears from evaporating too quickly. Meibomian gland dysfunction (MGD) is a blockage of the meibomian glands. With this blockage, they will not secrete enough oil into the tears to keep them balanced. MGD can present at any age, but is more common as we age, in women that wear makeup and sometimes a result of contact lens wear.

When chronic MGD is present, it can cause the glands to become blocked. Once the glands are blocked, they can become infected resulting in a stye. If the stye does not resolve, it can often result in a hard nodule called a chalazion. Even though these two bumps are similar, a stye tends to cause discomfort and pain and a chalazion is more or less annoying on the lid. While a chalazion can often go away on its own with at-home treatment, there are times where the chalazion needs to be removed. This can be done as a simple in-office procedure by your doctor.

Typically, warm compresses are used to treat MGD by heating the glands making it easier to express the oils to the eyes. More advance treatment options, like LipiFlow® and BlephEx®, are also used.

Dry Eye Syndrome