Blepharitis/Meibomitis

Symptoms

Itching, burning, mild pain, foreign body sensation, tearing, crusting around the eyes on awakening.

Signs

Crusty, red, thickened eyelid margins with prominent blood vessels or capped oil glands at the eyelid margins.

 

Treatment

1.   Warm compresses for 10 to 15 minutes two to four times per day to soften crusts at the base of the lashes

2.   Scrub eyelid margins twice a day with mild shampoo (e.g. Johnson’s baby shampoo) on a cotton-tipped applicator or a wash cloth, or use a foaming lid scrub (e.g. Steri-Lid) to mechanically remove crusts

3.   If associated with dry eyes, use artificial tears (e.g. Systane Ultra) 4-6 times per day

4.   If moderately severe, add erythromycin or bacitracin ointment to the eyelids at night

5.   Unresponsive meibomitis can be treated with tetracycline 250mg by mouth four times per day, or doxycycline 100mg by mouth once a day for one to two weeks, then taper slowly to one-fourth full dose for 6 months

a.   Tetracycline and doxycycline should not be used in pregnant women, nursing mothers, or children under 8 years old.  Erythromycin 200mg by mouth two times per day can be used instead

 

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