Challenges in the management of pediatric blepharokeratoconjunctivis / ocular rosacea

Moritz Claudius Daniel, Michael O'Gallagher, Melanie Hingorani, Annegret Dahlmann-Noor, Stephen Tuft
2016 Expert Review of Ophthalmology  
Childhood blepharokeratoconjunctivitis is a common lid margin inflammation with secondary ocular surface disease. Its etiology is unclear and there are no randomized controlled trials to support the superiority of any treatment option. Areas covered: We searched the following databases; Cochrane Central Register of Controlled Trials, Ovid MEDLINE and affiliated Ovid databases, EMBASE, the ISRCTN registry, and the World Health Organization International Clinical Trials
more » ... nical Trials Registry Platform. Due to the paucity of pediatric data we also considered information from articles focused on adults. Expert commentary: Treatment is based on the assumption that the mechanisms of BKC and rosacea keratitis are the same: meibomian gland dysfunction, bacterial colonisation of the lid margin, delayed type hypersensitivity, Demodex folliculorum, genetic predisposition and Toll-like receptors inducing release of pro-inflammatory cytokines. Generally accepted grading scales are needed. Randomized clinical trials are needed to evaluate treatment options. The effects of antibiotics, immunomodulators, osmoprotectants and essential fatty acids need further investigation. ARTICLE HISTORY
doi:10.1080/17469899.2016.1209408 fatcat:2o2t3pip6jf4doeadszj5bpqiu