Your eyelids contain tiny glands that make oil which keeps your eyes moist. In blepharitis, these glands become blocked, which causes your eyelids to become irritated and your eyes sore. In some cases, dandruff-like flakes build up at the base of the eyelashes. It is thought that, in some people, blepharitis is partly caused by sensitivity to the bacteria (staphylococcus) which normally live on the skin. The surface of the eye can become inflamed. The eye becomes red and sore and may develop small white ulcers around the edge of the cornea. This is called marginal keratitis.
This treats the blepharitis which causes marginal keratitis. You should carry out good ‘lid hygiene’ once or twice a day (even when you do not have any symptoms), to prevent marginal keratitis from recurring.
Use water that is hot, but not hot enough to burn. Soak cotton wool or a clean flannel in the water, wring out and gently press onto your closed eyelids for two to three minutes at a time. This melts the oily secretion blocking the openings of the glands and softens any lash flakes.
Massage your eyelids by gently rolling your index finger over them in a circular motion or running the length of your finger up and down your eyelids towards your eyelashes. This helps to push out the oil from the tiny eyelid glands.
Use a moistened cotton bud to gently clean the inside edge of your eyelids and more firmly scrub off any flakes on the lashes. This is best done in front of a mirror.
Antibiotic drops or ointment along with steroid drops can be useful in calming down any eye inflammation. Your eye doctor will discuss with you whether this treatment is suitable.
If your eye becomes increasingly red or painful, your sight becomes more blurred or you see white patches getting bigger on the cornea, you should call Moorfields Direct for advice (details opposite) or go to your local A&E department.
Authors: Miss Melanie Hingorani, Dr Swan Kang
Review date: June 2026