What causes blepharitis?

Updated: Jul 31, 2018
  • Author: Bobak Zonnoor , MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Anterior blepharitis is usually secondary to infection or seborrheic in nature, or else it is a combination of both. If the pilosebaceous glands of Zeiss and Moll become infected, an abscess may occur. This abscess is known as an external hordeolum, or stye. [22] Cell-mediated immunologic mechanisms have been implicated in the development of chronic blepharitis. [23, 24]

Posterior blepharitis is caused by Meibomian gland dysfunction. The Meibomian gland secretes the oily layer of the tear film. This oily layer is responsible for preventing excessive evaporation of the aqueous layer of the tear film. If the secretions become inspissated, causing plugging of the gland, a chalazion may develop. A chalazion is a noninfectious, granulomatous reaction. If there is infection secondary to plugging, an internal hordeolum develops. [25]

The use of eye makeup, especially eyeliner, can cause acute exacerbations of blepharitis by plugging the glands. [26]

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