Given the results and EUA findings the diagnosis was staphylococcal hypersensitivity/chronic blepharokeratoconjunctivitis (BKC) secondary to meibomianitis
, with corneal neovascularization and scarring [2, 3].
Modified from Management and therapy of dry eye disease: Report of the management and therapy subcommittee of the international dry eye workshop (2007) (1) Table 2 Level Treatment 1 Education and environmental/dietary modifications Elimination of offending systemic medications Artificial tear substitutes, gels/ointments Eyelid therapy 2 If level 1 treatments are inadequate, add: Anti-inflammatories Tetracyclines (for meibomianitis
) Punctal plugs Secretagogues Moisture chamber spectacles 3 If level 2 treatments are inadequate add: Serum Contact lenses Permanent punctal occlusion 4 If level 3 treatments are inadequate add: Systemic anti-inflammatory agents Surgery
To suppress chronic meibomianitis
, all patients were treated preoperatively for at least 1 month with 100 mg oral doxycycline (Monodoks[R], Deva, Turkey) once daily, topical 0.1% fluorometholone (FML[R], Allergan) four times daily as an anti-inflammatory therapy, and lubricating tear drops.
Huang SC et al (25) and others (15, 21) concluded that blepheritis and meibomianitis
had been shown to be leading contributors to bacterial keratitis.