Lid hygiene in the management of blepharitis

The College’s position on lid hygiene in the management of blepharitis.

Share options

The College’s Position

There is moderate quality evidence to support the use of lid hygiene as first line therapy for the management of blepharitis.  However, there is no strong evidence that any treatment can completely cure the condition. In the absence of high quality evidence, we believe that there is a need for further research comparing specific lid hygiene techniques to support future evidence based recommendations. We recommend that optometrists discuss specific lid hygiene techniques with their patients.


How we arrived at this position

An extensive literature search was undertaken in June 2018. Thirteen studies were identified that evaluated the effectiveness of lid hygiene in blepharitis of various aetiologies. Six of these studies used a randomised controlled trial (RCT) design. Compared to baseline, significant improvements were seen in symptoms and clinical signs for all methods used. There was insufficient evidence from comparative studies to make any recommendation based on the relative effectiveness of different methods of lid hygiene. However, the majority of studies evaluated were judged to have a high risk of bias.


Impact on patients and practitioners

Optometrists must ensure that they discuss treatment options with their patients, as there are both clinical and financial implications, and the treatment must be right for the individual patient. Optometrists should bear in mind that there is evidence that long term compliance with lid hygiene measures may be poor.


Useful links

Patient leaflets

Using evidence in practice

Blepharitis (Lid Margin Disease)

Last updated: October 2018