Oculase Articles

Blepharitis vs conjunctivitis: what’s the difference?

Mr Tariq Ayoub - 2 Apr 2024

You have red eyes, and they are painful. Do you have blepharitis or conjunctivitis? Symptoms for both conditions are very similar, and many people confuse their symptoms with the wrong issue.

However, the causes of these different eye problems are vastly different. In this article, we explain the difference between these two conditions and what to look out for.

What is blepharitis?

Blepharitis is inflammation that causes the rim of your eyelids to become red and swollen. People often experience repeat episodes of flare-ups followed by periods of no symptoms. It is not contagious, meaning you cannot catch it from somebody else.

Find out more about blepharitis here.

Symptoms

Symptoms caused by blepharitis include:

Causes

Common causes of blepharitis include:

  • Infections
  • Clogged oil glands
  • Hormone problems
  • An overgrowth of bacteria
  • Allergies
  • Parasites, such as Demodex eyelash mites
  • Skin conditions, such as dandruff, seborrhoeic dermatitis, or rosacea

What is conjunctivitis?

Conjunctivitis (also known as pink eye) is an eye infection that causes the inflammation of the clear tissue lining the outer coating of the eye and the inside of the eyelid. Conjunctivitis is common, and people can get the infection more than once. However, once treated, the infection will not cause reoccurring symptom flare-ups, unlike blepharitis. Conjunctivitis is highly contagious and can spread from person to person, also unlike blepharitis.

Symptoms

Symptoms caused by conjunctivitis include:

Causes

Common causes of conjunctivitis include:

  • Allergies
  • Irritating substances, e.g. shampoo, smoke, or cosmetics, getting in your eye
  • A foreign object in your eye
  • Viruses
  • Bacteria
  • Sexually transmitted diseases (STIs)
  • Autoimmune diseases

Can blepharitis cause conjunctivitis?

If you experience severe blepharitis, you may also be at risk of developing a secondary conjunctivitis infection called blepharoconjunctivitis. It’s caused by bacteria on the eyelid causing irritation and inflammation, that can also spread to the conjunctiva (a thin lining covering the inner eyelid and the white of the eye).

If you develop this type of infection, you may need to be treated with steroid eye drops, antibiotics, and, often, IPL treatment.

You may also be at risk of developing dry eyes or, occasionally, small corneal ulcers on the eye if you have severe blepharitis. It is important to seek advice about your condition, as we can help prevent these complications from occurring and treat any current health concerns.

Diagnosis

It can be difficult to distinguish between the two conditions, which is why we would recommend seek professional advice. If you are unsure of your condition but experience any of the symptoms mentioned in this article, we will help assess your health and identify the problem.

We will first evaluate your symptoms and check your medical and family history.

If we suspect it might be conjunctivitis, we may ask if you have:

  • Had a viral or bacterial infection recently
  • Any allergies
  • Gotten anything irritating (like chemicals or foreign objects) in your eye recently
  • Been diagnosed with an STI recently
  • A family history of autoimmune disease or other reason to think you have an autoimmune disease

We will perform an eye examination, regardless of the suspected condition. We will also take samples of any discharge and check your eyelashes, eyelids, and eyes for any concerns.

We are here to assist you with your health journey and guide you through our diagnostic process. Please let us know if you have any questions or concerns regarding these tests, especially if you have any anxiety about your eye.

Treatment

Treatment for these conditions is vastly different, but we will give you the right treatment plan based on our diagnosis.

For conjunctivitis, treatment will depend on the root cause of the condition. If bacteria or a virus has caused the issue, we may prescribe antibiotics or antiviral medication to help clear up symptoms. If it is caused by allergies, we may prescribe eyedrops to help control your reaction to the irritant.

For blepharitis, we may suggest a series of treatments depending on the cause of your condition. Generally, your symptoms will improve if you maintain a habit of cleaning your eyelids at least once a day at home. Learn more about how to treat blepharitis fast here.

  • For clogged oil glands – we may suggest meibomian gland expression to help unclog your glands. You may also need IPL therapy.
  • For Demodex mites – if regular cleaning is not effective enough to help control an overrun of mites, we may suggest a more advanced cleaning of your eyelashes with BlephEx™ treatment. BlephEx™ treatment involves an eye specialist using a medical-grade sponge to remove any bacteria, crusting and debris on your eyelashes and eyelids.
  • For skin conditions – we recommend treating your underlying skin condition first before treating your eyes. This could include a special shampoo for seborrhoeic dermatitis or antibiotic tablets for rosacea. If untreated, prolonged eye irritation and inflammation can cause a corneal ulcer.

Blepharitis, if untreated, can lead to various other eye problems such as stye, cyst, or even conjunctivitis. If you notice any issues with your eyes, you must seek an eye specialist immediately.

At Oculase, we can fully assess your eyes and recommend the best course of treatment for you. Book an appointment today to prioritise your eye health.

If you believe another professional has overlooked your blepharitis symptoms, we also offer a second opinion service.

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About the author

Mr Tariq Ayoub
Mr Tariq Ayoub, Consultant Ophthalmologist

Mr Ayoub has been rated as one of the top eye surgeons in the UK. He is a Consultant Ophthalmic Surgeon in London, based at Imperial College Healthcare NHS Trust, where he is also the Lead for the Emergency Department at Western Eye Hospital.

0330 128 1616

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