Pulsed oral azithromycin in mixed blepharitis – posology / regimen?

Just wondering what sort of intervals people use for this – though I realise it can be quite case specific. I’m currently favouring pulse duration 5 days  (2x250mg day 1, then 1x250mg for 4 days); if good response, repeat again in 3/52, then third repeat in 3/52 if resolution not satisfactory – so max 3 pulses … Continue reading "Pulsed oral azithromycin in mixed blepharitis – posology / regimen?"

Eyebag update (mainly for Scots)

Just received an email from one of the prescribing leads to confirm that Eyebag is on the Scottish drug tariff at £10.  She advises that this can be prescribed by IP optometrists where there is clinical need. She suggests that ideally we should wait on this item being on the local formulary, however in her … Continue reading "Eyebag update (mainly for Scots)"

Neuropathic pain in dry eye?

Morning all!  Everyone managing dry eye will be frustrated by the mismatch between signs & symptoms. There seems to be a sub-group of patients where this is extreme. An unbiased observer would have no hesitation about classifying their anterior segment as normal and yet their symptoms are unremitting, even with optimum lubrication. Anyone else find … Continue reading "Neuropathic pain in dry eye?"

Ivermectin for Demodex blepharitis

Just came across this view on youtube: https://youtu.be/sgav_kZ_Hi4 and the Ophthalmologist refers to using Ivermectin cream for treating Demodex blepharitis. Quick search on emedicines compendium shows that this is now available in UK, but its intended use is for the treatment of pustules due to rosacea? Anybody know anything about Ivermectin or know any Ophthalmologists … Continue reading "Ivermectin for Demodex blepharitis"

Angular Blepharitis?

I have a patient who has a red, irritated outer canthus. The skin looks almost cracked on one side and on the other it has a slight mucous appearance. I have prescribed an antibiotic ointment, Polyfax which after 2 days is helping symptoms. But I’m wondering what other people may prescribe or other diff diagnoses … Continue reading "Angular Blepharitis?"

MGD not responding to systemic – where next?

Like most of us I imagine I see a lot of MGD. Saw someone a few months ago where the main complaint was watery eyes and his lids were just congested – just low grade MGD. Lid hygiene, oc. CPHL bd and FML qds for 2/52 (then tapered) improved it drastically (so much so he … Continue reading "MGD not responding to systemic – where next?"

demodex and 1% ivermectin cream

https://www.youtube.com/watch?v=sgav_kZ_Hi4 is interesting. I am trying to become a demodex beliver… The advocation is for 1% ivermectin cream to the lash base at night for one month after lid scrubbing but needs “specialist pharmacy compounding” – I have no idea how to get this – any thought? Better that the irritation caused by tea tree oil … Continue reading "demodex and 1% ivermectin cream"