Purpose: to identify the role of laser scanning confocal microscopy (LSCM) in diagnostic and to assess the effectiveness of involutional blepharitis treatment. Material and methods. The study involved 32 patients (64 eyes) with chronic blepharitis aged in average 75.21±3.56 years. All patients completed questionnaire (SPEED), underwent Schirmer I, Norn tear break-up time and compression tests, had the number of functioning meibomian glands (NFMG) calculated. The patients’ eyelids were examined with LSCM, and the condition of conjunctiva was evaluated by microbiological study. The patients were also tested for Demodex spp. Based on the results of LSCM the patients were divided into two groups: atrophic and obstructive. The first group (13 patients, 26 eyes) was prescribed treatment of eyelid margins with «Blephaclean» tissues 3 times a day and artificial tears «Thealoz» 4 times a day. The second group (19 patients, 38 eyes) was recommended therapy with warm compress 2 times a day, application of eyelid gel «Theagel» 3 times a day and instillations of «Thealoz» 4 times a day. The follow-up began 2 months after therapy start. Results. Clinical-functional, morphological parameters and laboratory findings had a tendency for improvements after the treatment. The application of tissues, eyelid gel and artificial tears contributed to increase of NFMG, improvement of tear film stability and tear production. The treatment resulted in decreased secretion reflectivity of the lacrimal canal orifice and lower degree of heterogeneity of acinar and interstitial walls according to LSCM readings. Conclusion. The data acquired on the discriminate application of eyelid hygiene products based on LSCM and clinical-functional examination allows the recommendation of such therapy for the treatment of various forms of involutional blepharitis.