title: Diagnosis and management of chronic blepharokeratoconjunctivitis in children.
abstract: OBJECTIVE
  To describe the history, symptoms, and clinical signs and discuss the treatment of blepharokeratoconjunctivitis.
  
  
  METHODS
  Eight children (five girls and three boys), ranging in age from 3.5-13 years, were clinically diagnosed with blepharokeratoconjunctivitis. Microbiology studies were performed in four of the eight children. Treatment consisted of lid hygiene, oral erythromycin suspension, and preservative-free steroids. Duration of therapy was directed by clinical improvement.
  
  
  RESULTS
  Average age at onset was 3.2 years (range: 0.5-8 years). Lid disease, conjunctival redness, and inferior superficial corneal vascularization were consistent features (100%). Other signs were punctate corneal epithelial staining, inferior subepithelial vascularization and infiltrate, conjunctival phlyctenules, corneal phlyctenules, and circumferential pannus. Microbiology testing demonstrated coagulase-negative staphylococcus and Propionibacterium acnes. Average follow-up was 8.3 months (range: 2-23 months). All patients had relief of symptoms within 2-3 weeks. Clinical signs took more time to regress but all had progressive improvement of the ocular surface by 2 months. Blepharokeratoconjunctivitis reactivated in all patients during follow-up, and repeat therapy was administered.
  
  
  CONCLUSIONS
  Blepharokeratoconjunctivitis in childhood is a chronic inflammatory process that can have different presentations. It can be successfully treated with oral erythromycin and topical steroids.
authors.affiliation: Department of Ophthalmology, Save Sight Institute, Sydney Eye Hospital, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Farpour
authors.forename: K A
authors.initials: KA
authors.lastname: McClellan
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D017668:Age of Onset; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001762:Blepharitis / Q000175:diagnosis* / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004917:Erythromycin / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D007637:Keratoconjunctivitis / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D012008:Recurrence
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D004917:Erythromycin