Differences

This shows you the differences between two versions of the page.

Link to this comparison view

Both sides previous revision Previous revision
Next revision		 Previous revision
blepharokeratoconjunctitis [2025/11/02 20:21] – [Treatment] Scott Larsonblepharokeratoconjunctitis [2025/11/02 20:57] (current) – Scott Larson
Line 1: Line 1:
 ====== Pediatric Blepharokeratoconjunctivitis (PBKC) ====== ====== Pediatric Blepharokeratoconjunctivitis (PBKC) ======
-FIXME+==== Definition===
   * from PBKC Study group, "Pediatric Blepharokeratoconjunctivis is an underdiagnosed, sight-threatening, chronic, and recurrent inflammatory ocular surface disease affecting children and adolescents. Its clinical spectrum includes chronic blepharitis, meibomitis, conjunctivitis, and corneal involvement ranging from superficial punctate keratitis (SPK) to corneal infiltrates with vascularization and scarring"   * from PBKC Study group, "Pediatric Blepharokeratoconjunctivis is an underdiagnosed, sight-threatening, chronic, and recurrent inflammatory ocular surface disease affecting children and adolescents. Its clinical spectrum includes chronic blepharitis, meibomitis, conjunctivitis, and corneal involvement ranging from superficial punctate keratitis (SPK) to corneal infiltrates with vascularization and scarring"
-  * Multifactoral resulting in corneal leukoma, irregular astigmatism, corneal perforation and permanent vision loss. +  * Results in corneal leukoma, irregular astigmatism, corneal perforation and permanent vision loss. 
   * a.k.a. Staphylococcal blepharokeratoconjunctivitis, Ocular rosacea, Meibomitis- related keratoconjunctivitis, phlyctenular keratoconjunctivitis.    * a.k.a. Staphylococcal blepharokeratoconjunctivitis, Ocular rosacea, Meibomitis- related keratoconjunctivitis, phlyctenular keratoconjunctivitis. 
 +
 +====Risk Factors====
 +  * Poor hygiene
 +  * [[seborrheic_dermatitis|Seborrheic dermatitis]]
 +  * History of [[atopy|Atopy]]- predisposition to produce IgE in response to common allergens 
 +  * Infestation with Demodex mites
 +  * High levels of C.acnes bacteria in meibum cultures
 +
 +====Causes====
 +  * Presumed immunologic response to ocular surface antigens from bacteria (staphylococcus, cutibacterium, mycobacteria) or other agents or organisms (demodex) 
 +
  
 ====Treatment==== ====Treatment====
 +===Bacteria===
   * [[azythromycin|Azithromycin]]   * [[azythromycin|Azithromycin]]
-    * PO 250-500 mg thrice weekly for 4-8 weeks (5-10 mg/kg) in children over 8 with their adult teeth. +    * PO 250-500 mg thrice weekly for 4-8 weeks (5-10 mg/kg)  
     * Topical: Azasite 1% ophthalmic solution most useful in maintenance of remission     * Topical: Azasite 1% ophthalmic solution most useful in maintenance of remission
-  * [[doxycycline|Doxycycline]] 
-    * Low dose:  40 mg QD or 20 mg BID x 4-8 weeks or 2.2 mg/kg/day x 1-2 months  
-    * Regular dose: 100 mg QD x 4-8 weeks 
   * Erythromycin    * Erythromycin 
     * PO 250-500 mg QD or BID x 4-8 weeks     * PO 250-500 mg QD or BID x 4-8 weeks
-    * Topical: 0.5% ointment, most helpful for maintaining remission+    * Topical: 0.5% ointment, most helpful for maintaining remission   
 +  * [[doxycycline|Doxycycline]] in children over 8 with their adult teeth.     
 +    * Low dose:  40 mg QD or 20 mg BID x 4-8 weeks  
 +    * Regular dose: 100 mg QD x 4-8 weeks 
 +===Demodex=== 
 +  * Tea Tree Oil 50% eyelid scrubs daily 
 +    * [[https://www.amazon.com/s?k=tea+tree+oil+eyelid+wipes&crid=2S0A26H6IPQM4&sprefix=tea+tree+oild+%2Caps%2C251&ref=nb_sb_ss_p13n-expert-pd-ops-ranker_1_14 |Amazon search results]] 
 +  * [[https://xdemvyhcp.com |Xdemvy drops (lotilaner ophthalmic solution 0.25%)]] BID x 6 weeks 
 +    * Send to BlinkRx  Phone: 1-833-919-4942 Fax: 1-866-585-4631 12639 W Explorer Dr, Suite 100 Boise, ID 83713  NPI #: 1891461885