Blepharitis Vs. Chalazion: Eye Doctor’s Insights on Symptoms and Treatments

Written by Radhika Gholap, BS

Patients often ask “What is the difference between blepharitis and a chalazion?” When it comes to blepharitis vs chalazion there are a few differences. There is also a strong relationship between the two.

Blepharitis Vs. Chalazion: What Are They

While both blepharitis and chalazion impact the eyelid, they are different processes.

Blepharitis

Blepharitis is a general inflammation of the eyelid margins. This fairly common condition can lead to redness, swelling, and crusty flakes. This eyelid condition can exist without a chalazion.

Blepharitis has two primary classifications:

• Anterior Blepharitis: This affects the outer part of the eyelid where eyelashes grow.
• Posterior Blepharitis: This involves the inner part of the eyelid, affecting tiny oil glands.

Chalazion

While blepharitis is generalized inflammation, a chalazion is a painless bump. This bump is almost always found along with blepharitis. It can occur on the lower lid or on the eyelid skin of the upper eyelid.

Though typically not serious, both conditions can impact eye health and may require professional attention. 

Blepharitis VS. Chalazion: Causes And Symptoms

Both blepharitis and chalazia are common causes of eye discomfort. Blepharitis and chalazion can both cause redness, irritation, and even pain in and around your eyes. Understanding the differences between blepharitis and chalazion is crucial for effective treatment and relief. 

Blepharitis Causes And Associated Diseases

Blepharitis can be caused by bacterial infections or skin conditions like seborrheic dermatitis. 

Ocular Rosacea

Ocular rosacea is a form of acne rosacea that affects the eyes. It is also linked with blepharitis. The chronic inflammation of the skin and eyes can exacerbate blepharitis symptoms.

Seborrheic Dermatitis 

This skin condition, characterized by flaky, greasy scales on the scalp and face, often coexists with blepharitis. The overproduction of oils can lead to eyelid inflammation.

Atopic Dermatitis (Eczema)

People who have eczema are more prone to developing blepharitis due to the chronic inflammation and irritation associated with this skin condition.

Allergic Conjunctivitis

Chronic eye allergies can contribute to blepharitis, as constant rubbing and irritation of the eyes can inflame the eyelids.

Meibomian Gland Dysfunction (MGD)

This condition, where the oil glands in the eyelids don’t work properly, is closely associated with blepharitis and can lead to chronic inflammation and irritation of the eyelids.

Blepharitis Symptoms

If you have blepharitis, you may have the following symptoms:

• Red, swollen eyelids
• Gritty or burning sensation (“sand” in eye)
• Itchy eyelids
• Flaking skin around the eyes

If blepharitis is left untreated, you may develop chronic blepharitis. Here, symptoms can worsen over time and lead to constant discomfort. Chronic blepharitis can actually lead to chalazions also.

Chalazion Causes And Associated Diseases

Chalazion is a small, usually painless, bump that forms on the eyelid. It happens when one of the tiny oil glands along your lash line becomes blocked. This condition can occur on either the upper or lower eyelid.

Chalazion is associated with blepharitis and meibomian gland dysfunction. 

Chalazion Symptoms

A chalazion usually starts as a red, swollen area before becoming a hard lump. Unlike an internal or external hordeolum (stye), a chalazion is generally not painful. 

Blepharitis vs. Chalazion: How Are They Related?

Blepharitis and chalazion are highly related. A chalazion forms in severe cases of blepharitis.

Relationship Between Blepharitis And Chalazion

Blepharitis is known to contribute to the development of a chalazion. As the eyelids become inflamed over time, the oil glands are more likely to become blocked. This results in a chalazion.

Similar Symptoms

Although a chalazion is a mildly red or red bump. On the other hand blepharitis is generalized inflammation that usually affects the entire eyelid. They both can have watery eyes, and both of these can cause eye discomfort and pain. For many patients a chalazion may also be a painful lump.

Treatment Similarities

Both blepharitis and chalazion can improve with proper eyelid hygiene. This includes warm or hot compresses and a mild soap to help keep the area clean. If you have a chalazion already then you should be more aggressive with your warm compresses. 

Blepharitis Vs. Chalazion: Causes

As we now know, blepharitis and chalazion can sometimes be linked while other times have different causes. Let’s review what can cause these conditions.

Blepharitis 

Blepharitis can be caused by a variety of things. Usually, there is more than one factor at play.

• Bacterial infection: Commonly by Staphylococcus aureus, a common skin bacteria.
• Skin conditions: Such as seborrheic dermatitis or ocular rosacea.
• Demodex mites: Tiny parasites that can irritate your lid margin and eyes.
• Inflammation: Related to meibomian gland dysfunction, leading to blocked oil glands.

Chalazion Causes

​The bump from the chalazion can be causes by blepharitis as well as other multifactorial things. 

• Blocked oil gland: This occurs when meibomian glands become clogged.
• Meibomian gland dysfunction: This condition can cause abnormal oily secretions.
• Chronic blepharitis: This increases the likelihood of developing chalazia.
• Dry eyes: Insufficient tears may lead to irritation and blockage.

Blepharitis Vs. Chalazion: Risk Factors

Both conditions have similar risk factors. These include: 

• Poor eyelid hygiene: Neglecting to clean eyelids properly can lead to infections.
• Skin diseases: Conditions affecting the skin can increase susceptibility.
• Allergic reactions: Allergies may cause inflammation in the eyelid area.
• Fatty acids: An imbalance in fatty acids can affect tear production and eyelid health.

Oftentimes, blepharitis and chalazion may be caused by a combination of the above triggers. Your treatment may thus be multifactorial to address multiple causes.

Blepharitis vs. Chalazion: Diagnosis

Diagnosing blepharitis and chalazion is easy for an eye doctor. A chalazion is a clear bump on the eyelid. It is usually easy to feel by palpation. Blepharitis and meibomian gland dysfunction can be seen at the slit lamp and there is no discreet bump present.

Proper diagnosis is crucial because the treatments differ significantly. It is very important to provide a detailed history of symptoms to aid the doctor in making an accurate diagnosis. The eye doctor will then typically conduct a physical examination. They will look at the eyelid, check for bumps, and assess other symptoms. In some cases, additional tests might be necessary to rule out other conditions. 

Blepharitis vs. Chalazion: Treatment

Chalazion treatment is usually more aggressive than blepharitis treatment. Let’s take a look at how these two conditions are usually treated. 

Chalazion Treatment

Here are common ways to treat a chalazion.

• Warm Compresses: Applying a clean washcloth along the base of the eyelashes can be soothing. Try soaking the washcloth in hot water to better help unclog oil glands. This should be done for 10-15 minutes, 3-5 times a day, to prevent recurrent chalazia.
• Eyelid Massage: Gently massaging the edges of the eyelid can assist in drainage.
• Steroid Injections: In some cases, steroid shots may be administered to reduce inflammation.
• Incision: In cases where a chalazion keeps returning, a small incision may be needed to drain it under local anesthesia. This can be done in the clinic or the operating room depending on the size of the lesion.

Blepharitis Treatment

​Blepharitis treatment is similar to chalazion treatment. 

• Eyelid Scrubs: Regular cleaning of the eyelid margins with diluted baby shampoo can reduce irritation.
• Warm Compresses: Similar to chalazion treatment, warm compresses can help with inflammation.
• Topical Antibiotics: An antibiotic ointment may be prescribed for bacterial infections associated with blepharitis.
• Oral Antibiotics: In severe cases, oral tetracyclines may be recommended.

Blepharitis Vs. Chalazion: Prevention

Preventing blepharitis and chalazion involves good eye care habits. 

Good Eyelid Hygiene

Regularly cleaning the eyelid can reduce the risk of infection and inflammation. A gentle 5-minute wash with warm water or eyelid scrub pads is recommended. Try using gentle cleaners like baby shampoo or unscented body soap. 

Avoid Eye Makeup

Minimizing the use of eye makeup can help. If mascara, eyeshadow, and other makeup are used, make sure to properly clean off the makeup every night.

Contact Lenses Care

For contact lens users, proper cleaning and handling are essential. Always clean your hands with soap and water before changing your contacts. Using fresh solution and avoiding wearing lenses longer than recommended can prevent irritation. 

Make sure you do not sleep in your contacts either. If you are using long-term contacts (“weekly’s”, “monthly’s”), make sure you are disinfecting the contacts nightly and storing them correctly. 

Self-Care Measures

Warm compresses can help maintain healthy oil glands. Applying a warm compress for 10–15 minutes can help with oil flow and reduce blockage. 

Maintain Good Hygiene

Washing hands regularly and avoiding touching the eyes can prevent the transfer of bacteria. This is vital, especially for those prone to eye issues.

Incorporating these practices can significantly decrease the chances of developing blepharitis or chalazion. Regular visits to an eye doctor are also important for maintaining eye health and addressing any concerns early.

Blepharitis Vs. Chalazion: Summary

Blepharitis and chalazion are both common eyelid conditions that affect many people. You can protect yourself with eyelid hygiene. It is important to keep your lash line clean. You can do this with regular warm compresses and lid scrubs. If infected, it is important to distinguish between the two problems to properly treat your eyes. 

Blepharitis is an inflammation of the eyelids. It often causes redness, swelling, and irritation. Patients may notice crusty flakes on their eyelashes. This condition can be uncomfortable but is usually not serious. Regular eyelid cleaning is the main treatment method.

A chalazion, on the other hand, is a small, painless bump on the eyelid. It occurs when oil glands become blocked. Chalazia can be associated with blepharitis. Initially, they may be red and swollen but often resolve on their own within a few months. 

If you have tried treating your eyelid on your own, please go to a healthcare provider or an Ophthalmologist specifically. They can help you manage your condition.