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Blepharitis and conjunctivitis

Understanding blepharitis and conjunctivitis

Blepharitis and conjunctivitis are both inflammatory eye conditions.  Although they present with some similar symptoms such as itchy eyes and photosensitivity (sensitivity to light) (1, 2), they are two distinct conditions affecting different parts of the eye.

There are some possible common causes for both conditions, such as being of bacterial or viral origin, and whilst blepharitis can in some cases lead to conjunctivitis, an important distinguishing factor between them is that blepharitis is usually non-contagious, whereas conjunctivitis is often contagious (can be passed from one person to another).

Blepharitis is an inflammation of the eyelids and thought to be one of the most commonly encountered eye conditions, in the US alone an estimated 5% of patients visiting healthcare providers present with signs or symptoms of blepharitis, and over 37 – 47% of those attending appointments with ophthalmologists and optometrists (3).  In the UK 71% of cases of eye inflammation presenting to the emergency department are attributed to blepharitis and conjunctivitis (4).

Blepharitis may be acute or chronic.  Acute blepharitis symptoms tend to be present over a shorter period of time, and it can be ulcerative or nonulcerative.  Chronic blepharitis tends to present with symptoms over a longer period of time, or symptoms that keep recurring, and can be linked to meibomian gland dysfunction (MGD) or seborrheic blepharitis (1).  Research found that over 35% of chronic blepharitis diagnoses are associated with MGD and keratoconjunctivitis sicca (KCS) (5).

In cases associated with blepharitis, it is specifically ‘evaporative’ keratoconjunctivitis sicca, which is caused by loss of the tear film in the eye due to abnormally rapid evaporation, probably resulting from a degraded normal oil layer such as in seborrheic blepharitis.  This is sometimes also referred to as ‘dry eye’ (6).

Conjunctivitis is an inflammation or infection of the conjunctiva, which is the mucous membrane covering the sclera (white part of the eyeball). It is the most common eye complaint presenting in healthcare settings which features redness of the eye (7). Conjunctivitis is usually acute, which refers to symptoms lasting between 3 – 4 weeks (although this is usually 1 – 2 weeks and the condition is often self-limiting), chronic conjunctivitis is defined as lasting more than 4 weeks.

Many herbs are suitable for self-care. However if a health condition does not resolve with home remedies we recommend using the information in Herbal Reality along with your health advisors, especially herbal practitioners from the professional associations listed in our Resources page (‘If you want to find a herbalist”). When buying any herbal products, you should choose responsible manufacturers with independently assured quality standards and sustainability practices. Check the label carefully for the appropriate safety and sustainability information.

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