Corneal Effects of Tea Tree Oil

Cornea. 2021 Oct 1;40(10):1363-1364. doi: 10.1097/ICO.0000000000002776.


Purpose: The purpose of this study is to report a case of corneal epithelial defects resulting from topical treatment of blepharitis with tea tree oil (TTO).

Methods: A 44-year-old man with a 1 year history of blepharitis non-responsive to eyelid hygiene was found to have signs of Demodex infestation. He was treated with a topical, off-label 50% TTO solution. Shortly afterward, the patient complained of bilateral ocular discomfort.

Results: Slit-lamp examination revealed conjunctival injection and a corneal epithelial defect in both eyes. Treatment with lubricant, antibiotic, and steroid eye drops as well as bandage contact lenses was required to facilitate corneal healing.

Conclusions: Topical use of off-label, 50% concentration TTO can result in corneal epithelial defects. Eye care professionals should remain aware of this risk and only use approved, low-concentration TTO products when treating Demodex-related blepharitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Infective Agents, Local / adverse effects*
  • Blepharitis / drug therapy*
  • Blepharitis / parasitology
  • Corneal Diseases / chemically induced*
  • Corneal Diseases / diagnosis
  • Drug-Related Side Effects and Adverse Reactions / diagnosis
  • Drug-Related Side Effects and Adverse Reactions / etiology
  • Epithelium, Corneal / drug effects*
  • Epithelium, Corneal / pathology
  • Eye Infections, Parasitic / drug therapy*
  • Eye Infections, Parasitic / parasitology
  • Humans
  • Male
  • Mite Infestations / drug therapy*
  • Mite Infestations / parasitology
  • Slit Lamp Microscopy
  • Tea Tree Oil / adverse effects*


  • Anti-Infective Agents, Local
  • Tea Tree Oil