Marginal Keratitis

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  • Often chronic blepharitis
  • Subepithelial marginal infiltrates, typically separated from the limbus by a clear zone 1 2
  • Epithelial defects are typically smaller than the infiltrates
  • Fusion of smaller infiltrates and circular spread
  • Spontaneous resolution (without treatment) usually occurs within 3-4 weeks


  • Topical steroid therapy (e.g., Dexafree (dexamethasone) 4x/day or FML (fluorometholone) 4x/day)
  • Antibiotic coverage and treatment of accompanying blepharitis with Floxal (ofloxacine) and/or Tobrex (tobramycin) gtt/ointment (consider prescribing a combination preparation such as Tobradex)
  • Lid hygiene for blepharitis
  • Consider doxycycline p.o. (e.g., 100 mg 2x/day for 2 weeks, then 1x/day for 1 month, then 50-100 mg daily; Note: Erythromycin for children, pregnancy, or lactation) if recurring

Differential Diagnoses