From the Guidelines
Blepharitis treatment typically involves a combination of warm compresses, eyelid cleansing, and topical or oral medications. The goal of treatment is to manage symptoms and prevent recurrence, as a cure is usually not possible 1.
Treatment Options
- Warm compresses: Apply warm compresses to the eyelids for several minutes to soften adherent scurf and scales or discharge and/or warm the meibomian secretions 1.
- Eyelid cleansing: Perform brief, gentle massage of the eyelids, and use eye cleaners with hypochlorous acid at 0.01% to remove crusting from the eyelashes 1.
- Topical antibiotics: Use topical antibiotic ointments such as bacitracin or erythromycin to decrease bacteria from the eyelid margin in cases of anterior blepharitis 1.
- Topical anti-inflammatory agents: Use topical corticosteroids or cyclosporine to reduce inflammation and improve symptoms 1.
- Oral antibiotics: Use oral tetracyclines or azithromycin for patients with meibomian gland dysfunction (MGD) whose chronic symptoms and signs are not adequately controlled by eyelid cleansing or meibomian gland expression 1.
Important Considerations
- Patient education: Inform patients that warm compress and eyelid cleansing treatment may be required long term, as symptoms often recur when treatment is discontinued 1.
- Individualized treatment: Tailor the therapeutic plan to the patient's ability to perform treatment and consider their medical history, such as advanced glaucoma or neurotrophic corneas 1.
- Potential side effects: Be aware of potential side effects of medications, such as increased intraocular pressure, cataract, or cardiovascular risks associated with oral azithromycin 1.
From the Research
Treatment Options for Blepharitis
The treatment for blepharitis typically involves a combination of eyelid hygiene, topical antibiotics, and topical corticosteroids. The main goals of treatment are to relieve symptoms, prevent recurrence, and minimize the risk of complications.
- Eyelid hygiene regimen, which needs to be continued long term, is the mainstay of treatment 2, 3, 4, 5, 6
- Topical antibiotics are used to reduce the bacterial load 2, 4, 5, 6
- Topical corticosteroid preparations may be helpful in patients with marked inflammation 2, 5, 6
- Systemic antibiotics may be appropriate in some patients 2
- Omega-3 supplements may also be used as part of the treatment regimen 6
- Warm compresses, eyelid scrubs, baby shampoo, and over-the-counter eyelid cleansers may be used for anterior blepharitis 4
- Heat therapy/thermal pulsation treatment may be used for posterior blepharitis/meibomian gland dysfunction (MGD) 4
Considerations for Treatment
It is essential to note that blepharitis can present with a range of signs and symptoms, and its management can be complicated by various factors. The treatment modalities for managing lid margin diseases vary depending on the disease's cause, location, and severity.
- A combination of remedial measures that addresses eyelids hygiene and includes medicated and device therapy may be the most effective method of treating chronic blepharitis 3
- Fixed combinations of a topical antibiotic and a corticosteroid offer an effective and convenient treatment modality that addresses both infectious and inflammatory components of the disease 5
- Regular monitoring of patients undergoing systemic therapies, such as chemotherapy, is crucial to promptly set up adequate supportive therapy for blepharitis 6