Randomized trial of topical periocular castor oil treatment for blepharitis

Ocul Surf. 2021 Jan:19:145-150. doi: 10.1016/j.jtos.2020.05.007. Epub 2020 May 15.


Purpose: To evaluate the effects of topical castor oil application to the eyelids on ocular surface and tear film parameters in patients with blepharitis.

Methods: Twenty-six participants (14 females, 12 males; mean ± SD age, 38 ± 21 years) with clinical signs of blepharitis were enrolled in a prospective, investigator-masked, randomized, paired-eye trial. A 100% cold pressed castor oil formulation (Lotus Garden Botanicals, Biddeford, ME, USA) was applied to the eyelids of one eye (randomized), twice daily for 4 weeks. Ocular surface characteristics, symptoms, and tear film parameters were assessed at baseline and day 28.

Results: Baseline measurements did not differ between treated and control eyes (all p > 0.05). A significant reduction in OSDI symptomology score was observed following the four-week treatment period (p = 0.001). Clinical improvements in eyelid margin thickening, telangiectasia, eyelash matting, madarosis, cylindrical dandruff, and lid wiper epitheliopathy were limited to treated eyes (all p < 0.01), while greater decreases in staphylococcal and seborrheic eyelash crusting were observed in treated than control eyes (both p < 0.05). No adverse events were reported during the treatment period.

Conclusion: Topical castor oil application effected significant improvements in ocular surface signs and symptoms in patients with blepharitis. The favourable therapeutic profile would suggest that castor oil demonstrates promise as a potential treatment for blepharitis, and support the conduct of further efficacy trials with longer follow up.

Trial registration number: ACTRN12618000856213.

Keywords: Blepharitis; Castor oil; Demodex; Meibomian gland; Ocular surface; Ricinoleic acid; Tear film.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Blepharitis* / drug therapy
  • Castor Oil*
  • Eyelids
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Tears
  • Young Adult


  • Castor Oil