Chlorhexidine 0.02% treatment for refractory blepharoconjunctivitis

Purpose: To report the efficacy and safety of twice daily 0.02% Chlorhexidine in treating chronic refractory blepharoconjunctivitis. Methods: A case series of 10 patients with symptomatic, chronic, and resistant-to-treatment bilateral blepharoconjunctivitis were referred to our clinic. Conjunctival swab cultures were obtained, anterior segment photographs were taken, and all patients began treatment with 0.02% chlorhexidine administered twice daily. Clinical signs and symptoms were monitored over the follow-up period. Results: Of ten patients (20 eyes, mean age was 67.6 +/- 19.05 years), 6/10 had positive cultures of a resistant strain of Staphylococcus aureus or epidermidis previously treated with topical antibiotic drops. All patients showed complete resolution of conjunctival hyperemia and reported substantial improvement of symptoms after 2 weeks of treatment. At 1-month follow-up, the patients reported complete resolution of symptoms. Best corrected visual acuity (BCVA) before and after treatment differences were not statistically significant. Conclusion: Twice-daily application of 0.02% chlorhexidine appears to be a safe and effective treatment for patients with chronic, treatment-resistant blepharoconjunctivitis, offering significant symptomatic relief and clinical improvement.