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Back to Index New Considerations in the Treatment of Anterior & Posterior Blepharitis Although frequently seen disease entities, anterior and posterior blepharitis have long posed significant treatment challenges. The absence of effective topical medication has left only systemic medications and hygiene, both with limited efficacy, as therapeutic measures. Treatment is necessary, however, to relieve symptoms and improve the safety and outcomes of ocular surgery. Recent work with macrolide antibiotics has found that they possess antiinflammatory as well as antimicrobial properties; and some macrolides appear to penetrate and remain in tissues. This combination of traits makes these agents potential candidates for use in the treatment of eyelid disease. Discussion of the characteristics of macrolide antibiotics can be found in the systemic disease and respiratory disease literature, but little has been said on the subject in the ophthalmic literature. In this publication, five anterior segment specialists review the systemic literature, consider the etiology and natural history of blepharitis, and discuss the potential use of commercially available macrolide antibiotics for the treatment of anterior and posterior blepharitis. Learning Objectives: Discuss the etiologies of anterior and posterior blepharitis and state the difference between the two entities. List the topical therapeutic agents used in the treatment of anterior and posterior blepharitis. Describe the measures usedto treat anterior and posterior blepharitis that do not involve topical medication (include hygienic measures and systemic medications). Faculty: Eric Donnenfeld, MD; Francis Mah, MD; Marguerite B. McDonald, MD; Terrence O'Brien, MD; Kerry Solomon, MD View Faculty Bios New Considerations in the Treatment of Anterior and Posterior Blepharitis April 2008