Warning

Self-care is the recommended first line treatment for blepharitis including a stye (hordeolum) : lid hygiene, warm compresses, lid massage, gentle washing and avoiding cosmetics. Patients can access information here.

For orbital cellulitis see here.

Antimicrobial recommendations

If self-care ineffective after two weeks prescribe:

Chloramphenicol eye ointment 1% one application twice daily for 6 weeks.

On advice of ophthalmology if signs of meibomian gland dysfunction or acne rosacea

Oxytetracycline 500mg every 12 hours for 4 weeks (initial) followed by 250mg every 12 hours for 8 weeks (maintenance)

OR

Doxycycline 100mg daily 4 weeks (initial) followed by 50mg daily for 8 weeks (maintenance)

Noted this indication is off label and both Doxycycline and Oxytetracycline are contraindicated in pregnancy, lactation and children under 12 years.

Notes

For further information, see NICE CKS guidance on blepharitis.

Typical organisms: Staphylococcus aureus

Editorial Information

Last reviewed: 22/05/2025

Next review date: 22/05/2028