New York State Medical Treatment Guidelines for Blepharoconjunctivitis in workers compensation patients

The guidelines from the New York State Workers Compensation Board provide general principles for managing Blepharoconjunctivitis. These directives aim to assist healthcare professionals in determining appropriate strategies for diagnosing and addressing inflammation involving the eyelids and conjunctiva as part of a comprehensive care plan.

Healthcare practitioners specializing in Blepharoconjunctivitis can rely on the guidance from the Workers Compensation Board to make well-informed decisions about the most suitable approaches for assessing and treating this eye condition in their patients.

It is crucial to emphasize that these guidelines are not intended to replace clinical judgment or professional expertise. The ultimate decision regarding the management of Blepharoconjunctivitis should involve collaboration between the patient and their healthcare provider.



Blepharoconjunctivitis is a persistent inflammation of the eyelid along the base of the eyelashes. This condition leads to symptoms such as irritation, itching, watery eyes, mattering, frequent blinking, and may even cause sensitivity to light (photophobia). Various factors can contribute to its development, including insufficient oil gland production, bacterial infection, allergies, rosacea, and other underlying conditions.

Staphylococcal infection is a frequent culprit in causing blepharoconjunctivitis. It’s worth noting that the quality of the literature on this subject is generally lacking. While it’s commonly considered a non-occupational condition, its inclusion in the guideline ensures a comprehensive overview, as it is frequently identified during clinical evaluations.



Daily Lid Hygiene for Blepharoconjunctivitis: It is recommended for the treatment of blepharoconjunctivitis. The suggested frequency, dose, and duration involve daily eyelid and eyelash scrubbing using a cotton tip applicator or soft washcloth, along with perfume/dye-free soap and water. Alternatively, over-the-counter lid wipes may be utilized. Discontinuation is indicated upon resolution of symptoms, and a reduction in scrubbing frequency may be possible once the condition is under control.

Antibiotics for Blepharoconjunctivitis: Antibiotics are recommended for treating anterior blepharoconjunctivitis. This is especially true when lid hygiene alone proves insufficient, and antibiotics are initiated for clinical failures. Initial prescriptions of topical antibiotics may be particularly prescribed for more severe presentations.

Steroids for Blepharoconjunctivitis: Steroids are recommended for treating more severe cases of anterior blepharoconjunctivitis. It’s important to note that this treatment may lead to increased intraocular pressure (IOP). Therefore, prescription of steroids should only be done by an ophthalmologist or a healthcare provider with the capability to routinely, accurately, and regularly monitor IOP.

Indications: Steroids are indicated for moderate to severe anterior blepharoconjunctivitis. Typically, lid hygiene is initiated, and antibiotics are used for cases where lid hygiene alone is insufficient. Prescriptions of topical steroids, often in combination with antibiotics, may be recommended, especially for more severe presentations or to expedite symptom resolution.

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