Children with blepharitis often require specialized care

As a specialist in cornea and external disease, I will focus my comments on the topic of blepharitis in the pediatric age group. Our children in America are currently growing up in what many experts call an “obesogenic environment.” In the U.S., one in three children under the age of 11 years is overweight and one in six has a BMI high enough to be considered obese. This obesogenic environment includes a saturated fatty acid and refined sugar rich diet with too many calories per day, reduced outdoor activity and exercise, and a lifestyle that includes hours of near work, computer games and television. Besides obesity, this lifestyle change is contributing to an epidemic of myopia, diabetes, hypertension and, yes, even meibomian gland dysfunction, blepharitis, and the associated hordeoli and chalazia.The ideal treatment would include diet modification, increased exercise and resolution of obesity, but management of childhood obesity is complex and outside the purvey of most ophthalmologists. Because nearly all children in the U.S. are under the care of a pediatrician or family physician, most of us will delegate this potentially life-saving treatment to them. We can, of course, give encouragement.