Objective To study the clinical features of early anterior blepharitis in children by observing the condition of the ocular surface with an ocular surface analyzer. Methods In this descriptive study, both eyes of 40 patients (age range 4-14 years) who were diagnosed by slit-lamp examination to have anterior blepharitis were selected at Shanxi Eye Hospital (July 2015 to May 2016). Blepharitis was graded on the presence of signs: tear film break-up time, tear meniscus height, degree of ocular surface hyperemia, extent of meibomian gland absence, and corneal fluorescence staining scores measured by an ocular surface analyzer. Relationships among the measured signs were determined by Spearman correlation tests. Results Among the 80 eyes, 58 eyes (72%) had reduced tear film break-up time, 50 eyes (62%) had lower tear meniscus height, 15 eyes (19%) had corneal epithelial punctate defects, and more than a third of the meibomian glands in 25 eyes (31%) were absent. The score for signs of blepharitis had no obvious correlation with the average tear film break-up time, tear meniscus height, corneal fluorescence staining scores, or the degree of meibomian gland absence. However, the absence of meibomian glands was negatively correlated with the tear film break-up time (r=-0.253, P=0.024) and positively correlated with corneal fluorescence staining scores (r=0.563, P＜0.001). Conclusion The stability of tear film decreases in children with early blepharitis. Those with some degree of meibomian gland absence are at high risk for secondary dry eye.