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  • Anterior blepharitis: Crusty eyelids/eyelashes, collarettes (cylindrical dandruff at the root of eyelashes). Can be caused by staphylococci (S. aureus or epidermidis) or by seborrhoea
  • Posterior blepharitis: Meibomian stasis, dysfunction of the meibomian glands with alteration of the glandular secretion


  • Eyelid hygiene with warm compresses 1-2 x/d (e.g. with hot/cold packs) as permanent therapy, eyelid wipes (e.g. Blephaclean)
  • Fucithalmic gel (Fusidic acid) 2x/d or Oxytetracycline ointment 2x/d after eyelid hygiene 1-2x/d for 2-4 weeks, alternatively Posiformin 2% ointment (Bibrocathol) 1-2x/d (disinfecting)
  • Consider a combination with steroids: e.g. Blephamide ointmente (Sulfacetamid + Prednisolon) or Maxitrol ointment (Dexamethasone+Neomycin+Polymyxin-B-sulfate) or Tobradex ointment (Tobramycin+Dexamethasone) 3x/d for 2 weeks (CAVE: IOP rise!)
  • In chronic courses: e.g. Minocin Akne 50mg 2x/d for 4-8 weeks
    • approx. 1h before meals
    • Contraindication: Kidney and liver insufficiency, pregnancy, children under 12 years.

Differential Diagnoses

  • Demodex, allergic, chemical/toxic reaction


  • In case of unilateral, therapy-resistant blepharitis, think of sebaceous carcinoma of the eyelid!


  • EyeWiki Blepharitis
  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Nika Bagheri MD, Brynn Wajda MD, et al; Lippincott Williams&Wilkins; 7th Edition (2016)
  • Kanski’s Clinical Ophthalmology: A Systematic Approach; Jack J. Kanski MD, Brad Bowling MD; Saunders Ltd.; 8th Edition (2015)