Diagnosis and management of chronic blepharokeratoconjunctivitis in children.
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.
Farpour
B
B
Department of Ophthalmology, Save Sight Institute, Sydney Eye Hospital, Australia.
McClellan
K A
KA
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
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D004917:Erythromycin