What Is Eyelid Margin Disease?

Eyelid problems. PhotoAlto

Question: What Is Eyelid Margin Disease?

The eyelids play an important role in the health of the eyes. They protect the cornea and spread tears over the front of the eyes. Although several conditions can affect the eyelids, most eyelid disorders do not threaten vision. Eyelid margin disease refers to a common condition in which the eyelids are persistently inflamed. The condition produces dandruff-like flakes and debris that collect on the eyelashes and eyelid margins.

Patients with eyelid margin disease typically complain of constant itching, stinging, burning and redness.

Blepharitis, or inflammation of the eyelid margin, is one of the most common eyelid problems. Blepharitis is an uncomfortable condition that usually produces inflamed and itchy eyelids, but it doesn't permanently damage eyesight. Blepharitis can begin during childhood and may last throughout life. The best way to treat blepharitis is with good eyelid hygiene, including regularly cleaning the lids and lashes.

Types of eyelid margin disease

Anterior Blepharitis: Commonly caused by bacteria that build up on the eyelid and eyelashes. This bacteria is often present on our skin but in some individuals it tends to build up and grow to a greater level on the eyelid, lashes and eyebrows. Anterior blepharitis can also be caused by a mite called demodex. Demodex is very common and seems to be present in greater numbers on our skin as we get older.

Demodex infestation is present in 84 percent of the population at age 60, and 100 percent in patients older than 70. So the older you are, the higher the chance you may have more demodex. Although demodex is definitely present in higher amounts in people who do not practice good hygiene, it doesn’t necessarily mean you are doing a poor job with personal hygiene.

Posterior Blepharitis: Can be caused by excess oil production by the glands of the eyelids (meibomian blepharitis) which creates a favorable environment for bacterial growth. This is also commonly called meibomian gland dysfunction. The eyelid contains several glands -- called meibomian glands -- that contribute oils to the normal tear film. The glands are located inside the eyelid and have an opening on the eyelid margin. Some people are susceptible to these glands clogging or not functioning correctly on a chronic basis. Meibomian gland dysfunction is very common, and mild cases often go un-diagnosed or are not treated properly. Meibomian gland dysfunction also causes evaporative dry eye syndrome. Sometimes the glands will be plugged up. When meibomian gland dysfunction is chronic sometimes the glands will actually atrophy. The consistency and quantity of the tears can also be examined. If evaporative dry eye is present, the tears may seem thick or frothy.

Treatment of blepharitis

Blepharitis treatment varies depending on the cause, duration and other systemic medical problems a  person may have.

The mainstay of blepharitis treatment is to apply warm compresses several times a day followed by eyelid scrubs once or twice per day. Eyelid scrubs can be as simple as applying lathered baby shampoo onto a warm washcloth. The eye is closed and scrubbed with the washcloth using a gentle back and forth motion. Baby shampoo is recommended because it does not sting your eyes. 

Many eye doctors also prescribe topical antibiotic and antibiotic/steroid combination drops and ointments for the eye and eyelid. Oral antibiotics are also prescribed in hopes to quell the infection and inflammation.


American Academy of Ophthalmology,Eyelid Margin Disease. Medem, 2004.

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