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Dr. JP
Dr. JP, Ophthalmology, Oculoplastic Surgery
Category: Eye
Satisfied Customers: 28
Experience:  Harvard Medical School, Massachussetts Eye and Ear
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56 yr. old, w/m diagnosed with blepharitis secondary to

Customer Question

56 yr. old, w/m diagnosed with blepharitis secondary to ocular rosacea, worse on the left, with chronic left eye hemorrages, made worse with heavy exercise and use of vasodilating drugs and blod thining medications. Have d/c'd fish oil and multi-vitamin, and d/c'd simvastatin for cholesterol, though remain on beta blocker (antenonol) and lisinopril for b/p. Use daily warm eye compresses with lid scrubbing agent and eye-lid massage. redness and puffiness persists. prescribed doxycycline, and recently increased from 50 mg one time per day to two times per day and have been prescribed differing steroids. am currently using pred forte, one time per day in each eye. allergy testing revealed high sensitivity to mold and other seasonals. undergoing immunotherapy in sixth week of injections. no change. long term usage of o/t/c vaso constricting products but have d/c'd or limited usage for some time. Dr seems frustrsated with failure of response, as am i. any suggestions, questions?
Submitted: 7 years ago.
Category: Eye
Expert:  Dr. JP replied 7 years ago.

I treat blepharitis associate with ocular rosacea with topical tobradex solution 4 x daily, lid washes with ocusoft, warm compresses, probiotics, oral doxycycline tablet 100mg twice daily and metrogel to the nose and eyelid (ensure not to get in eye as it stings). Also need to stay away from inciting foods/drinks such as alcohol, spicy foods, salsas. Also recommend stopping the vasoconstricting eye solution as this causes rebound inflammation. Can use over the counter alaway or zatidor for itching and redness.



Customer: replied 7 years ago.
thanks. perhaps the docyccline dosage has been too low to be effective. do you agree given symptoms have persisted with little change? what probiotics do you suggest? my dr has not suggested tobradex and seems leery of stroids even though iop has been normal. am seeing adr at univ of michigan kellog center tomorrow for second opinion.