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Anterior blepharitis is a chronic condition characterised by inflammation of the eyelid margin. Symptoms include irritated, red, itchy or stinging eyes or eyelids, as well as fluctuating or blurred vision, and can fluctuate in severity over the day. As there are a number of different causes of anterior blepharitis, it is important to treat the underlying problem which can usually be determined over the course of a single consultation. Our optometrists at the Adelaide and Woodville branches of Innovative Eye Care use innovative equipment to determine the best course of action for treating blepharitis.

What causes anterior blepharitis?

Blepharitis is generally caused by an over-colonisation of micro-organisms along the lid margin, particularly along the eyelashes and the eyelash follicles. They release toxins which trigger inflammation along the eyelids, causing them to become red, swollen and crusty. The toxins can also enter the eye, producing more severe symptoms. This can be an underlying cause of eye infections such as conjunctivitis. Anterior blepharitis should not be confused with posterior blepharitis or meibomian gland dysfunction.

Demodex blepharitis

An important cause of blepharitis is demodex - small mites that inhabit the lid margins. Demodex mites are more common on our bodies as we get older, and every person over the age of 70 will have demodex mites on some area of the body. Demodex are resilient to conventional bacterial blepharitis treatments and require a more specific approach. Examination of the lashes under microscope is often needed to visualise the mites and make the diagnosis. This video describes more about demodex blepharitis:

Demodex blepharitis can be trickier to manage as the mites can be resistant to conventional blepharitis treatment. Alternative treatments involving multiple Bleph-Ex procedures using tea-tree oil and daily lid scrubs with Blephadex Eyelid Cleanser at home over many weeks are often necessary to eradicate demodex from your lashes. Certain patients, including those with roseacea, are more likely to react to the demodex mites and have symptoms. Talk to your optometrist for more detail about this if they suspect demodex blepharitis.


With treatment, blepharitis can be well managed. Treatment is aimed at maintaining good lid hygiene so that the eye can be non-irritated. Your lid hygiene routine may be performed more frequently in the beginning, and less frequently once under control. Once the blepharitis has settled, long term management is aimed at proper lid hygiene and maximising tear gland production.

SteriLid (also applies to Blephadex)

SteriLid is an antibacterial foam that gently cleanses the eyelids and lashes while conditioning the skin around your eyes. Linalool, a key ingredient in SteriLid, is a naturally-occurring liquid distilled from plant oils, including tea tree oil. Linalool has been formulated into SteriLid to create a gentle, pH-matched eyelid cleanser which cleanses while maintaining naturally antibacterial skin oils. SteriLid is available from our online store here.

Follow this procedure to use SteriLid:

  1. Shake the SteriLid bottle well before using.
  2. Clean fingertips with SteriLid and rinse.
  3. Pump SteriLid foam onto fingertips.
  4. Close eyes and massage foam gently into lids and eyelashes for 10 seconds. Avoid directly touching your eyes to prevent stinging. Try and massage as close to the base of the lashes as possible to remove the debris accumulating there.
  5. Leave in place for 60 seconds then rinse well with water.

In-office BlephEx treatment

This is a new and painless in-office procedure performed by your optometrist at Innovative Eye Care. A rotating cleaner removes debris on the lashes caused by blepharitis to assist home management and improve lid quality. Patients with demodex blepharitis benefit from this treatment with diluted tea-tree oil every 2 to 4 weeks.


Pflugfelder SC, Karpecki PM Perez VL. Treatment of Blepharitis: Recent Clinical Trials. The Ocular Surface Volume 12, Issue 4, October 2014, Pages 273-284

Hossain P, Konstantopoulos A. Blepharitis: remains a diagnostic enigma. A role for tea tree oil shampoo? Eye volume 29, pages 1520–1521 (2015)