Pediatric Blepharokeratoconjunctivitis (PBKC)

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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.
a.k.a. Staphylococcal blepharokeratoconjunctivitis, Ocular rosacea, Meibomitis- related keratoconjunctivitis, phlyctenular keratoconjunctivitis.

Azithromycin
- PO 250-500 mg thrice weekly for 4-8 weeks (5-10 mg/kg) in children over 8 with their adult teeth.
- Topical: Azasite 1% ophthalmic solution most useful in maintenance of remission
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
- PO 250-500 mg QD or BID x 4-8 weeks
- Topical: 0.5% ointment, most helpful for maintaining remission