From the Guidelines
Treatment for blepharitis in children should prioritize a consistent eyelid hygiene routine, with warm compresses and gentle lid margin cleaning using diluted baby shampoo or commercial eyelid cleansers, as the primary approach. This method, as suggested by the most recent study 1, helps loosen crusts and debris, reducing the risk of infection and inflammation. For moderate cases, antibiotic ointments such as erythromycin or bacitracin may be prescribed to apply thinly along the lid margins at bedtime for 7-10 days.
- Key considerations include:
- Avoiding aggressive pressure on the lids to prevent increasing eye pressure, especially in patients with advanced glaucoma 1.
- The potential use of topical perfluorohexyloctane, which has been FDA approved and shown to improve symptoms and corneal staining in patients with dry eye disease 1.
- Selenium sulfide as a compound that may help in meibomian gland dysfunction by breaking disulfide bonds and potentially unblocking the meibomian gland orifices 1.
- In severe cases, or when there's a suspicion of Demodex mites involvement, other treatments might be considered, such as tea tree oil-based products for older children or oral antibiotics like azithromycin, though with caution due to potential side effects and the need for medical supervision 1.
- It's crucial for parents to ensure children avoid eye rubbing, maintain good hand hygiene, and continue the cleaning regimen even after symptoms improve to prevent recurrence, as blepharitis often becomes a chronic condition requiring ongoing management 1.
From the Research
Treatment Options for Blepharitis in Children
- The treatment for blepharitis in children typically involves a combination of eyelid hygiene, topical antibiotics, and in some cases, oral antibiotics or corticosteroids 2, 3.
- Eyelid hygiene is a crucial part of the treatment, and children are often advised to use warm compresses, eyelid scrubs, and over-the-counter eyelid cleansers to clean their eyelids 4, 5.
- Topical antibiotics and antibiotic-steroid combination drops or ointments may be prescribed to reduce the bacterial load and inflammation 4, 5, 6.
- In some cases, oral erythromycin may be used as an alternative to tetracycline, which is contraindicated in children under 8 years old due to the risk of dental enamel abnormalities 2.
- Corticosteroid drops may be prescribed in cases with marked inflammation, but their use should be carefully monitored due to potential side effects 5, 3.
Specific Treatment Approaches
- For anterior blepharitis, treatment may involve topical antibiotics and eyelid hygiene, while posterior blepharitis may require additional treatments such as warm compresses or thermal pulsation therapy to clear obstruction in the meibomian glands 4.
- In cases with severe corneal involvement, more aggressive treatment may be necessary, including oral antibiotics and corticosteroids 3.
Considerations for Pediatric Patients
- Treatment of blepharitis in children can be challenging due to poor compliance with lid hygiene and therapy, and the need for alternative treatments due to contraindications or side effects of certain medications 2, 3.
- A thorough evaluation of the child's overall health and medical history is essential to determine the best course of treatment for blepharitis 5, 3.