What is marginal keratitis?

Marginal keratitis, sometimes referred to as staphylococcal marginal keratitis, is an inflammation of the outer edge of the cornea. The cornea is the clear dome-shaped window in the front of the eye. Its main job is to help focus light as it enters the eyes.

What causes marginal keratitis?

The most common cause of marginal keratitis is your body having a reaction to bacteria, called staphylococci. This is one type of normal bacteria that lives on your skin. An overgrowth of staphylococcal bacteria on the eyelid margins and on the eyelashes can lead to problems. It can cause an inflammatory reaction or sometimes a mild infection. The inflammation can then spread onto the surface of the eye (the cornea) with the exotoxins that the bacteria release. Patients with marginal keratitis may have the following symptoms:

  • Eye irritation
  • Red eye
  • Foreign body sensations, as if something is in your eye
  • Mucus discharge
  • Light sensitivity

How is marginal keratitis treated?

Marginal keratitis is treated by treating the underlying overgrowth of normal bacteria on the eyelid. The usual treatment is a combination of lid scrubs (special cleaning technique to the edge of the eyelid), warm compresses to the eyelids, and antibiotic ointment. Antibiotic and steroid eye drops may also be prescribed to reduce corneal inflammation more quickly. To treat with lid scrubs and warm compresses, follow these instructions:

  • Lid scrubs to remove particles from the eyelid and eyelashes. You can buy eyelid scrubs over the counter at the pharmacy or grocery store. You can also buy “no more tears” baby shampoo to make your own lid scrubs. Put three drops of the baby shampoo into a clean glass with 3 ounces of warm water (about ½ a cup). Take a clean washcloth and moisten it in your soapy solution. Gently wash your eyelashes with the washcloth. Close your eyes softly, as if you were sleeping, while you are washing the lashes. Make a new round of soapy water each time you wash your lashes.
  • Use a warm compress. Each eyelash has an oil gland that is supposed to lubricate the surface of the eye. The oil gland can get slightly clogged and the oil can become more solid, like “butter.” This makes it hard for your eye to absorb its natural oils. To “melt” the backed up oil in the eyelid margin, use a warm compress at least once a day. (Your doctor may recommend using it more often.) A warm compress is a clean washcloth that you heat under the hottest water that feels comfortable on your skin. Wring the washcloth out after you get it wet. Leave this compress on your eyes for 5 minutes. You may need to re-heat the washcloth to keep it warm for the full 5 minutes.