Blepharitis in Children

What is blepharitis in children?

Blepharitis is an inflammation in the oil glands of the eyelid. It causes swollen eyelids and crusting around the eyelashes. Even after it’s treated and goes away, it can often come back again and again for years. It can often lead to an infection of the eye and a loss of eyelashes.

What causes blepharitis in a child?

Blepharitis may be caused by either of these:

• An infection from bacteria

• An abnormal production and secretion of the oil-making (sebaceous) glands on the eyelid

The condition may also be linked to seborrheic dermatitis. This is an inflammation of the top layers of skin. It causes red, itchy, scaly skin.

Which children are at risk for blepharitis?

A child may be more at risk for blepharitis if he or she has:

• Seborrheic dermatitis

• Not enough tears on the eyes (dry eye)

What are the symptoms of blepharitis in a child?

Symptoms can occur a bit differently in each child. They can include:

• Redness and scales at the edges of the eyelids

• Burning feeling in and around the eyes

• Fluid seeping from the eyelids

You may also notice your child rubbing his or her eyes.

How is blepharitis diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask about your family’s health history. He or she will give your child a physical exam. Tests are not often needed to confirm the diagnosis.

How is blepharitis treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Severe cases of blepharitis may need to be treated by an eye doctor (ophthalmologist or optometrist).

The goal of the treatment is to ease the symptoms. Treatment may include:     

• Applying warm, moist compresses to your child's eyes for a few minutes several times a day

• Cleaning your child's eyelids daily. Use a clean, wet washcloth and a gentle baby shampoo. Rub your child's eyelids gently to remove the crusts. Use a different clean washcloth for each eye. Put the washcloths in the laundry after using.

• Telling your child not to rub his or her eyes

• Having your child wash his or her hands often

You may also need to:

• Wash your child's face and eyes daily. Use a clean, wet washcloth and a gentle baby shampoo. Rub your child's eyelids gently to remove the crusts. Use a different clean washcloth for each eye. Put the washcloths in the laundry after using.

• Put antibiotic ointment on the eyes. The ointment doesn’t make the blepharitis go away faster, but it may help to stop the infection from spreading to other parts of the eyes, or treat a secondary infection.

If your child also has seborrheic dermatitis, the healthcare provider may also tell you to:                                       

• Use an antifungal shampoo or cream

• Use a corticosteroid cream or lotion

• Softly brush your child’s head while washing with a mild baby shampoo 

What are possible complications of blepharitis in a child?

Blepharitis is a chronic condition. There are times when it goes away (remission) and times when it gets worse (exacerbation). Symptoms don’t often fully go away. In rare cases, severe blepharitis can lead to vision loss or lasting (permanent) changes in the eyelid edges.

Key points about blepharitis in children

• Blepharitis is an inflammation in the oil glands of the eyelid. It causes swollen eyelids and crusting around the eyelashes. 

• Even after it’s treated and goes away, it can often come back again and again for years. 

• Symptoms can include redness and scales at the edges of the eyelids.

• Treatment includes applying warm, moist compresses to your child's eyes for 15 minutes at a time several times a day. It may also include using antibiotic ointment on the eyes.

• Symptoms don’t often fully go away. In rare cases, severe blepharitis can lead to vision loss or permanent changes in the eyelid edges.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.