A couple of interesting points I didn’t know:

  • If lid hygiene is not controlling the symptoms, the next step is a prolonged course of topical antibiotics – two to three months. If that still doesn’t help, the next line is oral tetracycline for 6 – 12 weeks.
  • A complication of lid-margin disease (blepharitis, chronic staphylococcal keratitis, and probably some more obscure ones) is marginal keratitis, which is an immune-mediated inflammatory condition of the peripheral cornea. It presents with a red, painful eye and photophobia, developing gradually over several days, with localised conjunctival infiltration and a peripheral white corneal infiltrate. It is self-limiting, but treatment with topical steroids (plus topical antibiotics to protect the steroid-treated eye against infection) can shorten the course as well as relieving symptoms. It tends to recur, although treatment of the blepharitis with good lid hygiene reduces the frequency of episodes.

(Pulse on-line learning module)


About Dr Sarah

I'm a GP with a husband and two young children.
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