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.
Welcome to this short video on lid hygiene techniques which are useful for people with eyelid and tear film disorders.
Both the upper and lower lids contain many oil glands called meibomian glands. Your doctor may advise lid hygiene if these lands become blocked, leading to dry eye and inflammation
The first stage of lid hygiene is to soften the oils in the glands using heat with a warm compress.
One way to do this is to heat a flannel under the hot tap, wring it dry and make sure it's not too hot to touch. With this warm flannel hold it over the eyes, which are closed, for at least three minutes.
Alternatively, you can warm a microwavable eye bag bought from your local pharmacy following the manufacturer's instructions. Use this eye bag in a similar fashion to the flannel and hold it over the closed eyes for a minimum of three minutes.
The next stage unblocks the warmed oil glands using eyelid compression.
One technique is to express the oils by compressing your eyelid using the rolling motion of your finger. This aims to move the softened oils out of the glands and onto the surface of the eye.
Another way to achieve this is to use your index finger and thumb to squeeze the glands in the eyelid, this will allow that softened oil to come out of those block glands. A useful tip is to look in the opposite direction to the eye lid that you are currently pressing.
The final stage wipes away any bacteria and excess oils from your lid margin.
The aim is to clean both the front and the back of the eyelid margin.
Moisten a cotton bud and using this rub along the front of the eyelid margin and then followed by the back of the eyelid margin.
An alternative is to use a pre-prepared lid wipe available from your local pharmacy. Clean the eyelid margin in a similar fashion to when using the cotton bud.
Your doctor may prescribe you some eyedrops, in addition to advising to do lid hygiene. Pull down your lower eyelid and look upwards when administering your eyedrops.
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 or go to your local A&E department.
Authors: Miss Melanie Hingorani, Dr Swan Kang
Review date: June 2026