Staphylococcal Blepharitis Causes & Treatment | Eye Love Cares


Staphylococcal Blepharitis | Understanding What It Is: Causes & Treatment Methods

It is important to know about common ailments or diagnoses. Staphylococcal blepharitis is a common but potentially serious condition. To simplify it, staphylococcal blepharitis is the infection of the area around the eye. It involves the eyelashes, tear ducts, and oil glands within the eye. With so many kinds of blepharitis, the type depends on how the eye and surrounding areas are affected. If staph blepharitis is not treated properly, it could lead to larger infections and chronic dry eye.

Staphylococcal blepharitis is only one type of blepharitis. Blepharitis refers to the inflammation of eyelids. The inflammation takes the form of redness and irritation on the surface of the eyelid. It can also cause crusty residue, scabbing, and various discharges like pus and blood.

Staphylococcal blepharitis itself can also be broken down into two main categories by location of the ailment: anterior blepharitis and posterior blepharitis. There are also many causes and ways to treat staphylococcal blepharitis. Some of the causes can be as simple as a mite infestation or a bacterial invasion, or as serious as a viral infection.

What is Staphylococcal Blepharitis?

Staph BlepharitisStaphylococcal blepharitis is blepharitis caused by staphylococcus bacteria, otherwise known as staph bacteria most commonly heard of when discussing a staph infection. It is an infection of the eyelid and can become very serious. This is not an uncommon affliction and affects more than 20 million Americans at any given time. There is no one cause for staphylococcal blepharitis, or any type of blepharitis really. There are many contributing factors that can lead to this infection.

Blepharitis may also be called granulated eyelids because of the crusty buildup that collects on the eyelids due to the infection. Staphylococcal blepharitis is classified into several types: anterior blepharitis, posterior blepharitis, demodex, and seborrheic.

Types of Staphylococcal Blepharitis

Anterior Blepharitis

Anterior blepharitis is a form of staphylococcal blepharitis that targets the outside edges of the eyelid where the eyelashes sprout. When looking at the edge of the eye, there are two distinct sides and a wet fleshy divider. This infection most often occurs on the dry side. This is the area that is most exposed to the outside world. It comes in contact with the air, allergens, and the action of wiping or rubbing of the eyes.

Posterior Blepharitis

Posterior blepharitis affects the inner edge of the eyelid that touches the eyeball. This is the opposite side of the lid than anterior blepharitis affects, and this is also called meibomian gland dysfunction (MGD). It is directly in contact with the eyeball and connects to the whole interior of the eye socket. This area, of course, is less exposed to the direct elements but can easily be infiltrated by bacteria or mites.


Demodex are parasites that live in follicles and glands. Demodex is a known risk factor for pterygium and blepharitis. Demodex infestation is the most common cause of blepharitis.

Each Demodex mite has a semitransparent, longish body that has two segments, like an ant’s abdomen and thorax. There are eight legs that are all attached to the head-like segment. Their skin is covered in scales to help adhere to human hair and skin. Its mouth resembles an earwig’s, and these mites eat skin cells and various bits they come across while hiding.

Demodex infect and house themselves in the hair follicles of mammals. There are more than 65 different species of Demodex, but there are only two kinds of Demodex that live on humans: Demodex folliculorum and Demodex brevis.

Demodex folliculorum
  • Is a type of mite that is microscopic in nature and likes to live on the skin of humans near the eyes and eye follicles. D. folliculorum love to live inside hair follicles as their bodies are adapted to fit this environment perfectly. They are long and worm-like with short stubby legs. They measure 0.3 to 0.4 mm (0.012 to 0.016 in) long.

Demodex folliculorum may sound like something only very dirty people acquire, considering they resemble worms, but in fact every human has this form of mite living on their skin almost as soon as they are born. They are not harmful in and of themselves, but they can cause issues when they multiply.

Demodex brevis 
  • Is the second most common species of face mite that attaches itself to humans. They are a close relative to Demodex folliculorum but have many distinct defining factors of their own.

These mites are found in the sebaceous glands of the human body. The sebaceous gland is a very tiny gland built into the skin that has a purpose of secreting oily residue that liberates the skin and hair.  It is dispersed throughout the hair follicle, and this area is what attracts the mites.

Just like Demodex folliculorum, the Demodex brevis is not harmful on its own, though it can lead to other issues like infections.

Symptoms of Staphylococcal Blepharitis

Common symptoms of blepharitis include:

  • Itchiness
  • Soreness
  • Greasy eyelids
  • Sticky eyelids
  • Puffy or swollen eyelids
  • The feeling of something within the eye
  • Sensitivity to light
  • Abnormal acting eyelashes (like excessive eyelash loss)
  • Scarring
  • Rings of flakes along the edge of the eye
  • Hard crust on the eyelid

There are several different complications that can arise from staphylococcal blepharitis. The most common side effect is a cyst that grows inside the eyelid. A cyst on the eyelid can be very annoying. Other complications could include styes, pink eye, or other infections.

Diagnosing Staph Blepharitis

Staph BlepharitisBecause there are so many different types of blepharitis, it is important to determine which kind you’ve been afflicted with so that you can ensure a proper treatment option. An optometrist can determine the type of blepharitis based on the appearance of the eye and surrounding edges and lids. To compare the different types and get an idea of what each kind of blepharitis looks like, here is a description of each infection (however, the best source an optometrist who can accurately diagnose your infection):

  • Staphylococcal Blepharitis: As mentioned previously, staphylococcal blepharitis projects gooey sticky eyelids, swollen edges of the eye socket, and eyelash disappearance.
  • Seborrheic Blepharitis: Seborrheic blepharitis involves more of a topical change to the skin around the eye with the addition of greasy scales and flakey bits that collect around the base of the eyelid and can glue the eyelashes together. Mild eyelid redness is also common in patients who have seborrheic blepharitis, as this is a common symptom of many types of blepharitis.
  • Ulcerative Blepharitis: Ulcerative blepharitis can be very similar to seborrheic blepharitis in appearance. Both involve residue buildup, but ulcerative blepharitis has a hardened crust and residue rather than the liquid discharge alone. When the crust is picked off, it reveals oozing pus and bloodstreams, though more severe than the seborrheic blepharitis pus and discharge. It includes most of the symptoms that are basic to blepharitis infections like redness and inflammation.
  • Meibomian Blepharitis: Meibomian blepharitis involves less of a topical issue. Meibomian blepharitis occurs when the oil glands in the eyelids are blocked. This results in difficulty producing tears properly. It often causes poor quality and quantity of tears, meaningless are produced. It also leads to reddened eyelids and areas around the eyeball.

Causes of Blepharitis

Bacterial Infection

Bacteria are relatively complex despite being caused by single celled organisms. Bacteria can reproduce on their own and have existed for more than three billion years. The fact that bacteria have survived for so long is attributed to their ability to survive in various fluctuating temperatures, whether it is icy cold or sweltering hot. Bacteria can even survive in conditions that no other living organisms can, like within the human body and within radioactive waste. Believe it or not, only one percent of bacteria is actually harmful. Most bacteria are beneficial for humans, and they can help with daily tasks and fighting bad cells.

Viral Infection

Viruses can be very similar to bacterial infections, but they are even more minute in size.  Viruses are like their own living entities – they have the core of either RNA (Ribonucleic acid) or DNA (Deoxyribonucleic acid). Whereas bacteria can survive and reproduce on their own, viral particles must be a part of a host/hostess situation. In order to reproduce, the viruses must attach to another cell. This is how regular, healthy cells are made sick or malignant and can also be a way cells are weakened from cancer and other illnesses. Virus particles are very team-oriented and choose a specific type of cell to target depending on their composition.


Allergies, aka allergic diseases, are reactions to various triggers that are caused by hypersensitivity of the immune system to an otherwise harmless substance. It is an adverse reaction to a safe element, but because of the specific make up, it becomes dangerous.

There are many sorts of allergies ranging from hay fever and food allergies to asthma and rashes, etc. There are also different levels of severity; some people just get a cough or a small rash and others can go into anaphylactic shock, which can lead to death if not treated properly or quickly.


Rosacea is a skin condition that lasts a long time. As a result, Rosacea is not something that is constantly occurring visually, but it is always there whether invisible or not. There are flareups that affect the skin on the face. The most common reactions are skin redness, pimples, dilated blood vessels, and swelling. It’s most known for causing a light red-pinkish rash that covers the face focused in the cheek and nose area.

Though rosacea is very common and relatively harmless, the cause of rosacea is unknown although thought to be the result of bodily inflammation. The best recommendation is to stay away from any extremes of temperatures or anything that will touch and irritate the affected area. The condition can be exacerbated by heat, cold, sweat, sunlight, spices, alcohol, stress, or certain topical creams.

Treatment is typically done with metronidazole, doxycycline, or tetracycline.

Atopic Dermatitis

Atopic dermatitis, also known as atopic eczema, is a type of inflammation of the skin (dermatitis). Like most of these ailments, atopic dermatitis results in red and swollen skin.  It typically is something that affects children and can cover many areas of the skin. The younger the patient, the more surface area the condition covers. For older children and teens, the affected areas reduce to the back of the knees and the elbow area. For adults, it mostly covers the hands and feet. This condition can lead to infections and cause a greater risk of obtaining asthma.

Like rosacea, the cause of atopic dermatitis is unknown. Many scientists believe that it is linked to genetics within the realm of an immune system dysfunction. It could also involve exposure to certain elements like allergens.

Inflamed and Blocked Oil Glands

Blocked and inflamed glands occur at the edge of the eyelids. This is also called Meibomian Gland Dysfunction (MGD). This is a dysfunction that blocks or messes with the Meibomian glands so that there is not enough oil released to the tear ducts. The oil helps the tears from evaporating too fast, and it allows the prevention of dry eyes. MGD is the most common cause for having dry eyes. It is very closely associated with causing blepharitis.

Even though there are so many different causes, there are a large amount of blepharitis cases where the cause cannot be determined.

How is Blepharitis Diagnosed?

Blepharitis can be diagnosed through an eye examination. Ways to test include:

  • A discussion involving the patient’s history. Discussing the patient’s history helps to determine if the patient is experiencing general health problems that may be contributing to the blepharitis or if there are other outside factors causing the issues.
  • External examination of the eye. Obviously, for something that affects the physicality of the eye, it needs to be examined. It is important for a doctor to magnify the affected areas and observe the eye structure, texture, and appearance of the area around the eyes and lids.

The evaluation includes evaluating the edges of the eyelids too: the very edges where the eyelashes grow and the corners of the eyelids meet the eyeball. This area can be a great target because where the eyelashes grow, there are openings to the Meibomian glands. This examination can be done with a bright light and keen eye.

  • Swabbing skin for testing. Swabbing skin is a great way to bypass just simple hunches by optically observing and using hard scientific evidence. The skin sample is analyzed for bacteria, fungi, or evidence of an allergy, which is a certain way to pinpoint the exact cause without any speculation.
  • Evaluation of tears. The quality and quantity of tears can be evaluated to see if there are any oddities. An optometrist can determine the type of blepharitis accurately by simply looking at a patient’s tears. The reaction of their behavior can explain where there are issues within the eye.
Treatments for Staphylococcal Blepharitis

Routine washing of the eyelids is the simplest way to reduce symptoms and prevent future cases of staph blepharitis. The most aggressive treatments are over-the-counter lid scrubs, and eyelid hygiene should be performed consistently twice per day.

Typically, treating staph blepharitis is pretty easy. Make sure the area around the eyeball is clean; use not just water but an eyelid cleanser such as hypochlorous acid to make sure that there aren’t other bacteria being placed in the eye through the water.

Try the Heyedrate Lid and Lash Cleanser, which is a gentle hypochlorous acid cleanser. Simply spray it on your closed eyelids, rub it in, and let it dry. Simple as that!

You can also buy other cleaners made especially for eyes, and they’re widely available. There are eye cleaning pads that make the process simple and cleanup easy. If you decide to go this route, individually wrapped pads work well for many people who don’t like sprays.

Alternative Methods –

Another method is using a product with tea tree oil. The Heyedrate Tea Tree Oil Soap is great to use all over your body in the shower.

Prescription antibiotic ointments for the skin or droplets for the eyes can be used after the eye has been cleaned properly. Medications that can help fight the infection include:

  • Antibiotics (which must be prescribed by your eye doctor)
    • eye drops, creams, and ointments
    • oral antibiotics
    • antibiotics applied to the eyelid

Helpful tips to keep eyes safe and prevent outbreaks in the future

After recovery, it might be a good idea to replace makeup, especially eye makeup, that was used before and during the infection. Some examples would be pencil eyeliner, liquid eyeliner, mascara, liquid eyeshadow, and powder eye shadow. These items may have been compromised with the bacteria from the infection or could have been easily contaminated by outside sources and may be the cause of the staph blepharitis to begin with.

Blepharitis rarely disappears completely. Even with successful treatment, it can require daily care. Blepharitis is a chronic condition. Like herpes, it has periods of exposure and remission.

It’s important to be careful because some irritation or changes can be permanent.

Recent Findings

Recent scientific research has led to the newly discovered connection between blepharitis and early onset metabolic syndrome. Metabolic syndrome, sometimes known by other names, is a collection of three or more of the five following medical conditions:

  • High blood pressure
  • Obesity
  • High blood sugar/Diabetes
  • High serum triglycerides
  • Low high-density lipoprotein levels Metabolic syndrome can take a person down the path to diabetes and cardiovascular disease.

This is not some rare occurrence. More than a fourth of the population in the United States of America suffers from a kind of metabolic syndrome. The chances of acquiring this syndrome increase with age and can be even more prevalent among certain races.

Insulin resistance, metabolic syndrome, and prediabetes are closely related and are all tied together, relating back to staph blepharitis.

Ongoing Studies –

Not all of the facts and connecting pieces between insulin resistance, metabolic syndrome, and prediabetes have been discovered. It is very difficult to pinpoint exact locations for certain development of diseases. The study to grow the connection and similarities is ongoing.

Not only are insulin resistance, metabolic syndrome, and prediabetes connected to staph blepharitis, but so is Demodex, which was also a recent discovery. Demodex, like mentioned before, are mites that live within the eye ducts and lashes of the eye. They can also live in any hair follicles on the scalp and nose too. Demodex has been revealed and discovered as the seemingly most common cause of staph blepharitis.

Staphylococcal blepharitis can be very intricate and confusing but can also be very simple. Though it is caused by staphylococcus bacteria, otherwise known as staph bacteria, it does have many forms and ways it can affect a person.

Final Summary

Staph blepharitis breaks down into several categories – anterior blepharitis and posterior blepharitis – which essentially are determined by the location and severity of the infection.

Staphylococcal blepharitis also has many various causes and connections to other medical conditions. Its biggest contributor is Demodex – a small, very common mite that lives eternally on the human skin that can make its home in really any hair-covered area and feeds off skin and oil secretions.

These Demodex mites can themselves be separated into 65 species, but only two live on human hair: Demodex folliculorum and Demodex brevis. These two forms of Demodex are the most common explanation for most of staph blepharitis outbreaks. Out of the two, Demodex folliculorum is the most common type of Demodex. Therefore, Demodex folliculorum live on the skin of the human body and near eyes and follicles. The Demodex brevis mites live in the glands near the hair follicles, typically around the eyes where oil is produced. Just like the Demodex folliculorum, Demodex brevis is not harmful on its own, though it can lead to other issues like infections when overpopulated.

Diagnosis –

Diagnosis can be difficult, but it is important to find out what kind of blepharitis patients have so that proper treatment can be administered. Make sure to be familiar with all the types of blepharitis so there is a base knowledge of what is and is not occurring around the optical area.  Like mentioned before, there are several types of blepharitis: staphylococcal blepharitis, seborrheic blepharitis, ulcerative blepharitis, and Meibomian blepharitis.

Once the diagnosis of staph blepharitis is secured, it’s important to figure out the cause. Studies consider there to be many potential causes: a bacterial infection, a viral infection, many types of allergies, rosacea, atopic dermatitis, inflamed and or blocked oil glands, etc. Even with all of these potential causes, sometimes the cause cannot be determined.  

The most common symptoms of staphylococcal blepharitis include soreness, greasy eyelids, sticky eyelids, puffy/swollen eyelids, the feeling of something in your eye, light sensitivity, abnormal acting eyelashes, and scarring and/or rings of flakes along the edge of the eye.

Treatments –

Treatments include the routine washing of the eyelids, the simplest way to reduce symptoms and prevent future blepharitis. The most aggressive treatments are over-the-counter lid scrubs and sprays which should be used twice per day, every day.

Typically, treating staph blepharitis is pretty easy. Make sure the area around the eyeball is clean using an eyelid cleanser. You can also use a warm cloth to sooth the affected area, massage the eyelids with a cloth, and remove all residue. If the treatment does not help, try going for a prescription made especially for eyes. Increasing the sterility helps keep out and remove bacteria and the causes of the ailment.

Remember to see a doctor to diagnose the condition, and do not rely on your own hunches. It is important to get a professional opinion because sometimes conditions do not always match with the stereotypical symptoms or reactions. However, it is not harmful to have an idea of your ailment before being treated, so you are aware of where the doctor’s visit may go and what treatment may be necessary.

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