Blepharitis in Cats

What Is Blepharitis in Cats?

Blepharitis in cats is inflammation of the eyelids. It often occurs simultaneously with inflammation of the pink inner lining of the eyelids (conjunctivitis or “pink eye”). If the eyelids are very swollen, blepharitis may limit the cat’s field of vision.

Blepharitis is very common in cats and most will develop it at some point in their lives. If an infection is causing blepharitis, the infection may be contagious to other cats.

Blepharitis is not typically an emergency unless there is trauma to the eye due to an accident. Blepharitis may cause your cat to paw at their eye, risking injury. Placing an e-collar or recovery cone on your cat until they can see a veterinarian may help reduce self-injury to the eye while you wait for your appointment.

Symptoms of Blepharitis in Cats

Blepharitis itself is a symptom of an underlying cause. The signs of blepharitis in cats include:

• Swollen eyelids

• Redness, scabbing, or crusting of the eyelids

• Rubbing or pawing at the affected eye(s)

• Sores or wounds around the eyes

• Watery or thick, clear to green discharge from the eyes

• Loss of hair (alopecia) around the eyes

• Concurrent conjunctivitis

Causes of Blepharitis in Cats

There are many causes of blepharitis in cats, including infections or parasitic infestation, allergy, autoimmune issues, congenital or developmental problems, and injury.

Infectious and parasitic causes of blepharitis include:

• Ringworm (dermatophytosis)

• Bacterial infection, such as Staphylococcus

• Demodex mites or mange

• Insect or spider bites

• Fungal infection such as cryptococcosis

With sudden allergic reactions triggered by bug bites or medications, the eyelids may swell as part of the initial reaction.

Chronic allergies in cats typically appear as inflammation in the skin rather than hay fever signs seen in humans. Though the eyelids aren’t specifically affected in most cats with chronic allergies, they sometimes swell due to environmental or food allergies.

Autoimmune conditions that can cause blepharitis in cats include pemphigus (an autoimmune disease of the skin) or systemic lupus erythematosus (which can affect many systems in the body).

Congenital or developmental causes include:

• Entropion (eyelid rolled in)

• Ectopic cilia (eyelash disorders)

In these cases, eyelid swelling often occurs due to hair or fur irritating the cornea (outer clear layer of the eye), which may cause the cat to rub and paw at their eyes.

Wounds on the eyelid or trauma to the eye region can also cause eyelid swelling. Examples of injuries include a scratch in a cat fight, bites to the head, or blunt trauma to the eye region.

How Veterinarians Diagnose Blepharitis in Cats

The veterinarian can diagnose blepharitis in cats through simple physical examination. Importantly, blepharitis itself is not a disease but rather a symptom of another problem.

To determine what is causing swelling of the eyelids, your veterinarian may perform additional tests including:

• Looking into the back of the eye (fundic exam).

• Staining the eye to look for ulcers.

• Testing for upper respiratory infections, which usually involves taking a swab of the inside of the eyelids, nose, and/or throat and sending to a laboratory.

• Sedated examination of the eyelids to check for eyelash abnormalities, masses, or foreign objects under the lids.

• Cytology or skin scrape of the skin around the eyes, which involves looking under a microscope for infectious organisms or cell abnormalities.

• Blood tests to check systemic health and rule out feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV).

To help the veterinarian with the diagnosis, pet parents should discuss:

• The cat’s vaccination history

• How long the signs have been occurring

• Any trauma to the eye

• Any other affected animals in the home

• History of upper respiratory infections

• Whether the cat tests positive for FeLV or FIV

Treatment of Blepharitis in Cats

If an infection is suspected, medications may be prescribed either to go topically within the eye or orally. Examples include:

• Doxycycline (oral antibiotic)

• Azithromycin (oral antibiotic)

• Amoxicillin with clavulanic acid (oral antibiotic)

• Oxytetracycline and polymyxin B (topical antibiotic)

• Idoxuridine (topical antiviral)

• Famciclovir (oral antiviral)

• Itraconazole (oral antifungal)

Do not use triple antibiotic ointments or ocular ointments meant for humans in your cat’s eyes. Your veterinarian will usually recommend topical or oral parasiticides if mange is the cause.

For eyelid abnormalities, surgery may be required. For example, if the eyelids are rolled in (entropion), a procedure will be done to turn the eyelid outward. If there is an abnormal eyelash growing inside the eyelid, the follicle may be frozen (cryosurgery) to prevent regrowth.

Allergic causes of inflamed eyelids will be managed based on what is causing the allergy.

Treatments may include antihistamines, medications such as cyclosporine, immunotherapy (allergy shots), or dietary changes. 

Recovery and Management of Blepharitis in Cats

With treatment, most infectious causes of blepharitis should improve within seven to 14 days.

Infection with ringworm may result in a slower recovery time. Keep in mind that ringworm is contagious to other animals and humans, so use caution when handling your cat. Consider wearing gloves and washing your hands and isolating the sick cat from other pets in the home. Speak with your veterinarian about ways to ensure your home environment is kept clean.

With proper treatment, mange-induced inflammation usually improves within several weeks. Fungal infections such as cryptococcus can be difficult to treat, with treatment sometimes lasting for months.

If your cat had surgery due to an eyelid abnormality, recovery takes about two weeks. Your vet may recommend an e-collar to help aid in the recovery process. It’s absolutely essential that your cat’s e-collar remains in place until your veterinarian clears you to remove it. If your cat can rub at or scratch the eye, they can damage their surgical site.

Some cats with eyelid infections may be predisposed to developing them again, especially if they have an underlying condition that weakens their immune system like FIV.

Keeping your cat on flea and tick preventatives and up to date on their vaccinations can help mitigate the risk of infectious or parasitic blepharitis.