Blepharokeratoconjunctivitis in children.
OBJECTIVE
To evaluate the incidence, history, symptoms, clinical signs, and treatment outcomes of blepharokeratoconjunctivitis in a pediatric population at a tertiary cornea practice.


METHODS
In a retrospective case series, we reviewed the medical records of all new pediatric patients from January 1, 1997, through December 31, 2002, noting the reason for referral and subsequent diagnosis. We further noted the history, clinical characteristics, and treatment outcomes of the patients with blepharokeratoconjunctivitis.


RESULTS
Review of 195 medical records revealed that blepharokeratoconjunctivitis was the most common single diagnosis at consultation, accounting for 15% of referrals. Of the 29 cases identified, there were 16 girls (55%) and 13 boys (45%). The mean age at consultation was 6(1/2) years (age range, 2-12 years). On initial ophthalmologic examination, 11 (38%) of 29 patients were taking full-strength steroids and 4 patients (14%) were taking oral erythromycin. Oral therapy, in the form of erythromycin (n = 21) and doxycycline (n = 1), was prescribed to most patients (22/29 [76%]). Therapy with topical steroids was tapered at the initial visit in all patients. Follow-up was available for 15 of 29 patients, with a mean follow-up of 5.4 months (range, 2-25 months). The condition of all patients showed clinical improvement. Recurrences were noted in 6 (40%) or 15 patients; all were successfully managed with low-potency steroid therapy.


CONCLUSIONS
Blepharokeratoconjunctivitis is a common reason for cornea referral in children. Oral erythromycin therapy is an effective treatment with a steroid-sparing effect. Recurrences are common and may be successfully managed with low-potency steroid therapy.
Hammersmith
Kristin M
KM
Cornea Service, Wills Eye Hospital, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pa 19107, USA. Khammersmith@willseye.org
Cohen
Elisabeth J
EJ
Blake
Timothy D
TD
Laibson
Peter R
PR
Rapuano
Christopher J
CJ
D000284:Administration, Oral; D017668:Age of Onset; D001762:Blepharitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004917:Erythromycin / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007637:Keratoconjunctivitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D015143:Philadelphia / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome
D005938:Glucocorticoids; D004917:Erythromycin; D004318:Doxycycline