Blepharitis and styes

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Self-care is the recommended first line treatment for blepharitis including a stye (hordeolum) : lid hygiene, warm compresses, lid massage, gentle washing and avoiding cosmetics. Patients can access information here.

For orbital cellulitis see here.

Antimicrobial recommendations

If self-care ineffective after two weeks prescribe:

Chloramphenicol eye ointment 1% one application twice daily for 6 weeks.

On advice of ophthalmology if signs of meibomian gland dysfunction or acne rosacea

Oxytetracycline 500mg every 12 hours for 4 weeks (initial) followed by 250mg every 12 hours for 8 weeks (maintenance)

OR

Doxycycline 100mg daily 4 weeks (initial) followed by 50mg daily for 8 weeks (maintenance)

Notes

For further information, see NICE CKS guidance on blepharitis.

Typical organisms: Staphylococcus aureus