From the Guidelines
Blepharitis treatment should start with a consistent daily eyelid hygiene routine, including warm compresses and gentle cleaning of the eyelid margins with diluted baby shampoo or commercial eyelid cleanser, as this approach has been shown to significantly improve symptoms 1.
Key Components of Blepharitis Treatment
- Warm compresses to loosen debris and oil
- Gentle cleaning of the eyelid margins with diluted baby shampoo or commercial eyelid cleanser
- Artificial tears to relieve dry eye symptoms
- Omega-3 fatty acid supplements to improve meibomian gland function
Additional Treatment Options
- Antibiotic ointments like erythromycin or bacitracin for moderate to severe cases
- Oral antibiotics such as doxycycline (100mg once or twice daily) or azithromycin for more stubborn cases
- Topical steroids like loteprednol or fluorometholone to reduce inflammation
- Anti-dandruff shampoo for the scalp and eyebrows for seborrheic blepharitis
In-Office Procedural Treatments
- Vectored thermal pulsation therapy to improve meibomian gland function and reduce dry eye symptoms
- Microblepharoexfoliation to provide debridement and exfoliation at the lid margin
- Meibomian gland probing to unclog the meibomian glands
Important Considerations
- Blepharitis is often chronic, requiring ongoing management rather than a cure
- Treatment should be tailored to the individual patient's needs and response to therapy
- Patients should be informed of the potential adverse effects of treatment options, such as preservative toxicity and corticosteroid use 1
From the FDA Drug Label
DOSAGE AND ADMINISTRATION: The ointment should be applied directly into the conjunctival sac 1 to 3 times daily. In blepharitis all scales and crusts should be carefully removed and the ointment then spread uniformly over the lid margins. The treatment for blepharitis involves applying bacitracin ointment directly into the conjunctival sac 1 to 3 times daily, and:
- Removing all scales and crusts from the lid margins
- Spreading the ointment uniformly over the lid margins 2
From the Research
Treatment Options for Blepharitis
The treatment for blepharitis varies depending on the cause, location, and severity of the disease. Some of the treatment options include:
- Eyelid hygiene with warm compresses, eyelid scrubs, baby shampoo, and over-the-counter eyelid cleansers for anterior blepharitis 3
- Topical antibiotics and antibiotic-steroid combination drops/ointments for the eye and eyelid to reduce the bacterial load and inflammation 3, 4, 5
- Heat therapy/thermal pulsation treatment to clear obstruction in the meibomian glands and restore meibum secretions for posterior blepharitis/meibomian gland dysfunction 3
- Systemic antibiotics for some patients, particularly those with severe disease or associated systemic conditions 4
- Topical corticosteroids to help reduce inflammation in cases of severe blepharitis 4, 5, 6
- Omega-3 supplements to help reduce inflammation and promote healing 7
Management Strategies
The main goals of blepharitis treatment are symptom relief, recurrence prevention, and complication risk minimization. Management strategies include:
- Long-term eyelid hygiene regimen to reduce the risk of recurrence 4, 6
- Regular monitoring for patients undergoing systemic therapies that may cause blepharitis as a side effect 7
- Combination therapy with topical antibiotics and corticosteroids for effective and convenient treatment 6
Emerging Treatments
Various other compounds are in the late stages of development for managing lid margin diseases, including blepharitis 3. Further clinical trials are needed to determine optimal therapies for managing blepharitis 6.