Blepharitis

[Rebecca Petris]

A propos of all the recent discussions/debates about MGD, please note this Eyeworld quickie report from a presentation by Dr. McCulley at the ASCRS meeting going on in Hawaii.

Emphasis mine.

Discussing the classification of blepharitis, James McCulley, M.D., noted four basic types: staphylococcal, seborrheic, primary meibomitis (MKC), and meibomian gland dysfunction. The pathophysiology of chronic blepharitis can be attributed to both biochemical abnormalities of the meibum as well as bacterial lipolytic exoenzymes, but not to a single bacterium.

Dr. McCulley stressed that therapy should not be used to cure the disease but to provide relief and control.

Mechanical and hygienic measures include hot compresses, massage, and lid scrubs.

Recommended topical antibiotic treatments include bacitracin, fluoroquinolones, aminoglycides, and tetracyclines.

Systemic antibiotics are only indicated in severe cases of acute bacterial blepharitis, secondary meibomianitis, and MKC. Recommended systemic antibiotics include tetracycline analogues (including minocycline), and macrolides.

[skygoddess]

I find it telling, and a bit depressing I might add, that everyone seems to accept the idea that a cure is somehow impossible,
and we should just be happy with some measure of control of symptoms.
I want more.

[rhad]

They are doctor's why would they want a cure? their is no profit in cures....... as of yet, conventional medicine has been of no use to me..... they are treating the symptoms not the cause of your ailment.... that's like putting a band-aid on a bullet wound (without removing the bullet).

[stella]

I cant understand it ??- nobody ever mentions the use of chloramphenicol when mentioning topical antibiotics
Being from GB it is really the only topical antibiotic easily available to us for eyes (It is an over the counter ointment for the eyes at the strength of 1%) usually used for bacterial conjunctivitis
I was prescribed this by my GP when i developed an eyelid cyst - chalazion -It cleared that up well and i discovered it was great for my blepharitis
SO i have used it ever since - just a tiny smear on each lid margin at night,also over the outer lids and amazingly it resolved my night time problem of eyelids sticking to eyeballs, and during the day i hardly ever need drops now .
Chloramphenicol is a broad spectrum antibiotic .
The only problem i encountered was certain brands were in a mineral oil base which irritated my eyes (although good for the lids)but there is one make based in soft white paraffin and it is OK.
I have never established whether it is the emolient effect of the ointment or the antibacterial effect which is working for me - could be both - anyway it IS working for me and i just thank God and go on using it

[skygoddess]

Stella,
What is the brand name of the paraffin based one?

[stella]

Hi skygoddess - its hard to say 'cos i get an NHS version of it prescribed by my GP - which is the only version in that paraffin base
There are many other versions including "optrex infected eye" -an OTC ointment - but it contains" polyethelene in mineral oil "which does not suit me
It may however suit you -- try googling chloramphenicol eye ointment 1.0%
The NHS version is just "chloramphenicol eye ointment 1.0%" in a 4 gm tube produced by Medcom consultancy Ltd,Faraham Hants UK
Manufacturer - Tubilux Pharma S p A - Rome, Italy
I assume this is the cheapest version - since NHS always uses the cheapest option ( Its pathetic is'nt it - but thats what we are up against here - bargain basement medecine) In this case it is working for me so i should not complain
I've just come back from my optometrist for an annual check up - He is very pleased with my eyes - He stained and anaesthetized them before photographing them and was able to tell me that the tear film was thin but intact
When i told him i had been using chloramphenicol ointment and how much it had helped - he said to continue with it and he could not see any problems , except that if i did get an eye infection it may not work for me 'cos i had developed immunity to it --- I'll deal with that if and when it occurs
I'm off for some vacation in an RV so when i return i may try a few non- antibiotic options Cheers

[Jade]

Cure

I'm with you, skygoddess. We need a cure.

[skygoddess]

Stella,
Thanks for all the info. Have a nice Holiday , as you guys say.
For us its a Vacation.

[cookie]

eye oinment

I cant understand it ??- nobody ever mentions the use of chloramphenicol when mentioning topical antibiotics
Being from GB it is really the only topical antibiotic easily available to us for eyes (It is an over the counter ointment for the eyes at the strength of 1%) usually used for bacterial conjunctivitis
I was prescribed this by my GP when i developed an eyelid cyst - chalazion -It cleared that up well and i discovered it was great for my blepharitis
SO i have used it ever since - just a tiny smear on each lid margin at night,also over the outer lids and amazingly it resolved my night time problem of eyelids sticking to eyeballs, and during the day i hardly ever need drops now .
Chloramphenicol is a broad spectrum antibiotic .
The only problem i encountered was certain brands were in a mineral oil base which irritated my eyes (although good for the lids)but there is one make based in soft white paraffin and it is OK.
I have never established whether it is the emolient effect of the ointment or the antibacterial effect which is working for me - could be both - anyway it IS working for me and i just thank God and go on using it

do you ask pharmacist or find it on the aisle?
cookie

[cookie]

oinment

stella~do you find it on the aisle, what store?????
cookie

[Jillian Basler]

Blepharitis

Hi There,


Has anyone lost eye lashes due to blephritis? I have
Blepharitis/ Rosacea/ Dry skin and my top lashes are falling out, but
the lower ones are growing.

Thanks
Jill

[GinaJ]

I have bleph and my eye lashes used to fall out. They still do but not nearly as much as before. I really keep up with my lash cleaning because when they become filled with stuff I think the weight makes them fall off quicker. Maybe I am wrong though. I wish there was a cure too. I feel there should be some kind of ointment for the under lids to sooth them. Not just the preservative free drops.

[Jillian Basler]

Bleph

Yes, I aggree, I wish there was a cure too. What do you clean your lashes
with and how many times a day?