What is the treatment for blepharitis?

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From the Guidelines

Blepharitis treatment should start with warm compresses and eyelid cleansing, as these methods have been shown to provide symptomatic relief and improve meibomian gland function 1. The treatment of blepharitis involves a combination of eyelid hygiene and medications.

  • Warm compresses should be applied to closed eyelids for several minutes to loosen crusts and oil buildup.
  • Gentle lid scrubbing using diluted baby shampoo or commercial eyelid cleansers on a clean washcloth or cotton swab should be performed.
  • For moderate to severe cases, topical antibiotics like erythromycin or bacitracin ointment can be applied to the lid margins at bedtime for a few weeks.
  • Oral antibiotics such as doxycycline or azithromycin may be prescribed for more severe cases, particularly those with rosacea.
  • Topical steroids like corticosteroids may be used briefly for inflammation, but only under medical supervision due to potential side effects. Some key points to consider when treating blepharitis include:
  • The importance of proper counseling for patients with neurotrophic corneas to avoid injury to the corneal epithelium.
  • The need for patients to understand that a cure is usually not possible, but continual daily treatment can significantly improve symptoms.
  • The potential benefits of topical perfluorohexyloctane, which has been shown to improve symptoms and corneal staining in patients with dry eye disease 1.
  • The use of in-office procedural treatments, such as vectored thermal pulsation therapy or microblepharoexfoliation, which may improve meibomian gland function and reduce dry eye symptoms 1. The optimal treatment regimen often requires persistence and a trial-and-error approach, and the ophthalmologist should consider the patient’s ability to perform the treatment and tailor the therapeutic plan accordingly 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. El tratamiento para la blefaritis incluye:

  • Aplicar el ungüento directamente en el saco conjuntival 1 a 3 veces al día.
  • Remover cuidadosamente todas las escamas y costras y luego aplicar el ungüento de manera uniforme sobre los márgenes de los párpados. 2

From the Research

Tratamiento para la Blefaritis

La blefaritis es una condición oftálmica común con múltiples etiologías y no tiene un tratamiento definitivo y universal. A continuación, se presentan las opciones de tratamiento para la blefaritis:

  • Higiene de los párpados: con compresas calientes, limpiadores de párpados, champú para bebés y limpiadores de párpados de venta libre 3.
  • Antibióticos tópicos: y combinaciones de antibióticos y esteroides en forma de gotas o pomadas para el ojo y el párpado 3, 4, 5.
  • Terapia de calor: o pulsación térmica para desbloquear las glándulas de Meibomio y restaurar las secreciones de mebomio para mantener un film lagrimal saludable 3.
  • Azitromicina: en solución oftálmica al 1% en DuraSite para el tratamiento de la blefaritis posterior 6.
  • Eritromicina oral: como alternativa a la tetraciclina en el tratamiento de la blefaritis en niños 7.

Tipos de Blefaritis

La blefaritis se puede clasificar en:

  • Blefaritis anterior: que afecta el margen anterior del párpado y las pestañas 3, 5.
  • Blefaritis posterior: caracterizada por la disfunción de las glándulas de Meibomio 3, 5.

Consideraciones adicionales

Es importante tener en cuenta que la blefaritis es una condición crónica y que el tratamiento puede variar dependiendo de la causa, ubicación y gravedad de la enfermedad 3, 4, 5. Además, es fundamental la higiene de los párpados y el uso de agentes terapéuticos que reduzcan la infección y la inflamación 4, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Blepharitis: current strategies for diagnosis and management.

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie, 2008

Research

Azithromycin in DuraSite for the treatment of blepharitis.

Clinical ophthalmology (Auckland, N.Z.), 2010

Research

Oral erythromycin treatment for childhood blepharokeratitis.

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 2000

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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