AAO Preferred Practice Pattern 2018 for Blepharitis
The American Academy of Ophthalmology (AAO) has updated its 2013 Preferred Practice Pattern (PPP) guidelines for Blepharitis. Blepharitis is a chronic ocular inflammation that involves the eyelid margin primarily and is a common cause of chronic ocular irritation.

Blepharitis can be classified according to anatomic location: anterior blepharitis affects the eyelid skin, base of the eyelashes and the eyelash follicles, and posterior blepharitis affects the meibomian glands. This PPP covers the three clinical subcategories of blepharitis: staphylococcal, seborrheic, and meibomian gland dysfunction (MGD).

Highlighted findings and recommendations for care include the following:-
• In the management of ocular surface disease, it is helpful to distinguish blepharitis and meibomian gland dysfunction (MGD) from aqueous deficient dry eye. Worsening of symptoms in the morning is typical of blepharitis, whereas worsening of the symptoms later in the day are typical of aqueous deficient dry eye.

• Blepharitis is typically a chronic condition that cannot be permanently cured, and successful management is dependent on patient compliance with a treatment regimen. This should be explained to the affected patient.

• Topical antibiotic ointments with or without corticosteroids or oral antibiotics can be used effectively in the treatment of blepharitis. Although azithromycin is used as a treatment for blepharitis, it may be hazardous when used orally in patients with cardiovascular problems. Specifically, oral azithromycin may lead to abnormalities in the electrical activity of the heart, with the potential to create serious irregularities in heart rhythm.

• In patients with blepharitis who do not respond to therapy, the possibility of carcinoma or immune-mediated diseases should be considered, particularly if the blepharitis is associated with a loss of eyelashes and/or conjunctival cicatricial changes. Early diagnosis and appropriate treatment can prevent disfigurement and may be lifesaving.

About AAO
The American Academy of Ophthalmology (Academy) is a professional medical association of ophthalmologists. It is headquartered in San Francisco, California. The Academy's stated mission is "to protect sight and empower lives by serving as an advocate for patients and the public, leading ophthalmic education, and advancing the profession of ophthalmology."

Note: This list is a brief compilation of some of the key recommendations included in the Guidelines and is not exhaustive and does not constitute medical advice. Kindly refer to the original publication here: https://pxmd.co/eh98b and https://pxmd.co/38ZQG
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