Staying with my “back to basics” theme after returning from my all-too-short summer sojourn at the beach, I thought it appropriate to talk about one of the most fundamental problems we face when treating dry eye syndrome and ocular surface disease: blepharitis.
When I think back on my days as a resident at New York University, the most indelible memory I have is explaining blepharitis to patients — what it is and how it is treated — and how many times I recited the same story each day in the eye clinics. Blepharitis probably taught me more about patient communication than any other single thing in my residency.
The diagnosis and treatment of blepharitis, like dry eye syndrome (DES), is in a kind of Renaissance period. We can thank the late, much-lamented company Inspire and the promotion of AzaSite (azithromycin ophthalmic solution, Akorn) (more on this in a bit).
For decades, all blepharitis was considered roughly the same, and the treatment was simple, straight-forward, inexpensive and effective, to a point. Think back to how you diagnosed and treated blepharitis. Your patient either had it or not. There was no differentiation between anterior or posterior blepharitis, and only a cursory exploration for the presence of seborrhea was done, if at all.
Click here to read the full publication exclusive, The Dry Eye, published in Ocular Surgery News U.S. Edition, November 25, 2014.