RISK FACTORS: Candida, Seborrheic dermatitis, Acne rosacea, Diabetes mellitus,
Immunocompromised state (AIDS, chemotherapy, etc.)
GENERAL MEASURES:
β’ Mild seborrheic blepharitis (dry flakes, minimal inflammation) - apply eyelid margin scrubs with eyelid cleanser at least once daily
β’ If Staphylococcus likely, follow lid scrubs with application of bacitracin, or (second choice), erythromycin
ophthalmic ointment, to eyelid margins, using cotton tipped applicator
β’ Clean lids and apply ointment nightly in mild cases, up to four times daily in severe cases
β’ Discontinue soft contact lenses until condition cleared
β’ Chronic recurrent blepharitis requires referral to ophthalmologist for evaluation as to whether patient should
continue in lenses
DRUG(S) OF CHOICE:
β’ Topical treatment, if Staphylococcus likely, application of bacitracin, or (second choice), erythromycin ophthalmic ointment
β’ In some cases of Staphylococcus blepharitis (e.g., rosacea), systemic tetracycline 250 mg qid x several
weeks, tapering to 250 mg daily for one to three months, or doxycycline 100 mg bid po. Alternative is oxacillin 250 mg qid for 1-2 weeks. Used for persistent (despite topical treatment) lid infl ammation or recurrent
meibomian styes.
POSSIBLE COMPLICATIONS:
β’ Hordeolum (stye)
β’ Scarring of eyelid margin
β’ Misdirection of eyelashes (trichiasis)
β’ Corneal infection