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Blepharitis - Management
What should I do if initial treatment is inadequate?
- Ask about eyelid hygiene. If this has been complied with, but is ineffective on its own, consider offering antibiotics (if not already tried):
- Topical antibiotics should usually be tried first, especially if there are signs of staphylococcal infection on the anterior lid margins. A 6-week trial course is usually adequate. Chloramphenicol eye ointment is a suitable first-line option; fusidic acid eye drops are an alternative.
- Consider prescribing oral tetracyclines if topical antibiotics have failed to elicit an adequate response, or if there are signs of Meibomian gland dysfunction or rosacea. Low-dose tetracycline, oxytetracycline, lymecycline, or doxycycline for 6–12 weeks is recommended. Repeated courses are often required intermittently.
In depth
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