The eyelids are a thin layer of skin that helps protect the eye and possess very small structures that contain glands that provide protection and nutrients to the surface of the eye (cornea) that must remain constantly moist. This structure is also responsible for spreading the tear film evenly across the eyes. This is also the main defense against foreign material, including dust, allergens and other airborne pathogens. 

 Problems arise when resident bacteria, that at first may seem to cause no noticeable issues, begins to colonize into the conjunctiva and lacrimal systems. Recent estimates have identified over 200 species of bacteria commonly inhabit the human conjunctival mucosa (moist part of our eyes). The structure of the eyes is very high in nutrients creating a breeding ground for bacteria to proliferate and modify proteins to provide a protective cover which is a film-like meshwork, commonly know as Biofilm. This Biofilm is similar to plaque buildup on teeth in that it is very difficult to remove without special tools. This bacteria-constructed Biofilm environment provides physical protection and allows the bacteria to communicate which increases their potency and ability to infect and "fight off" our natural defenses that are meant to help prevent the formation of Biofilm.  

 Several risk factors have been noted to expedite the buildup of the Biofilm. Including but not limited to contact lens use, ocular surgeries, and potentially extended computer use. This Biofilm causes multiple negative changes to the overall structure of the eye, blocking glands from producing the correct balance of tears, increasing inflammatory cells that cause additional irritation, redness, discomfort, crusting, foreign body sensations, blurred vision, chalazions (styes), and many other ocular disorders. As the Biofilm thickens, it provides a comfortable home for other organisms, such as demodex, which is a parasitic facial mite that feasts around the lash follicles and can look like "dandruff".