Blepharitis
For general guidance on administration of drugs to the eye and on control of microbial contamination of eye drops, please see the ‘General information on eye drops’ recommendations.
Self-care (see prescribing notes)
One application every 12 hours trial for 6 weeks. Frequency and duration of treatment is guided by severity and response to treatment.
If signs of meibomian gland dysfunction or rosacea also a problem
100mg once daily for 2-3 months.
Prescribing Notes:
- Bathing eyes and increased hygiene may be all that is necessary to treat blepharitis.
- The eyelid can be cleansed by wetting a cloth with cleanser (for example, baby shampoo diluted 1:10 with warm water) and gently wiping along the lid margins to clear any lid debris.
- Eyelids should be cleaned twice daily initially, then once daily as symptoms improve.
- In addition, a warm compress (a clean cloth warmed with hot water) should be applied to closed eyelids for 5-10 minutes once or twice daily; compresses should not be too hot as this may burn the skin.
- Eyelid hygiene should be continued even when symptoms are well controlled to minimise number and severity of relapses.
- For posterior blepharitis, a brief gentle eyelid massage following the use of a warm compress can help improve expression of Meibomian gland secretions. Care must be taken to prevent mechanical irritation.
- Pressure on the eye area should be avoided in people with glaucoma.
- For further information, see NICE CKS guidance on blepharitis.
- Cosmetics should be avoided.
- If hygiene measures are ineffective after 2 weeks offer a trial of chloramphenicol eye ointment.
History Notes
19/06/2023
Update to doxycycline dose, ERWG May 23.
15/12/2021
East Region Formulary content agreed.
Self-care (see prescribing notes). Blepharitis in children can be managed by optometrists in the community.
Continue self-care (see prescribing notes) with a trial of antimicrobial eye drops.
See BNFc for dose, duration up to 2 weeks.
Continue self-care (see prescribing notes) with a trial of antimicrobial eye drops.
Initial trial to be applied twice daily after lid hygiene for 2-4 weeks. Frequency and duration of treatment is guided by severity and response.
Prescribing Notes:
- For more information on self-care measures refer to NICE CKS: Blepharitis.
- Patient information on Blepharitis is available from the NHS and Association of Optometrists.
- Bathing eyes and increased hygiene may be all that is necessary to treat blepharitis. Cosmetics should be avoided.
- Watery, intermittently sticky eyes in infants are often due to blocked tear ducts. Massaging the tear duct, eye lids, gently scrubbing off any flakes from the eyelashes and application of a warm compress may be effective.
- Antibiotics may be indicated if the eye is red or hygiene measures are ineffective after 2 weeks.
History Notes
15/01/2024
East Region Formulary content agreed.