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    Experts offer top blepharitis tips


    Laura Periman, MD

    Redmond, WA

    I teach that MGD and blepharitis is best addressed by understanding “The BEIST.” This is my way to organize the OCEAN paper1 and the Baudouin et al Vicious Circles paper.2

    B: Bacterial and demodex component. Try Avenova (hypochlorous acid, NovaBay) and intense pulsed light (IPL) therapy.

    Related: Incorporating meibomian gland imaging

    E: Enzymatic compromise. Optimize the meibum biochemistry.

    I: Inflammation. Address the inflammatory burden with omegas, immunomodulators, loteprednol (Lotemax, Bausch + Lomb), and IPL.

    S: Stasis. Blink. Debride lid margin. Express. Use thermal pulsation (LipiFlow, TearScience).

    T: Temperature. Use warm compresses and thermal pulsation.

    Up next: Scott Schachter, OD


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