What initial treatment is recommended for blepharitis?

The recommended initial treatment for blepharitis is the use of topical agents, such as topical erythromycin. Blepharitis, which is an inflammation of the eyelid margins, often results from seborrheic dermatitis or bacterial colonization, specifically by Staphylococcus species. Topical erythromycin, an antibiotic, is effective in reducing the bacterial load and eliminating any associated bacterial infections that may exacerbate the condition.

In addition, the management of blepharitis typically includes eyelid hygiene practices, such as warm compresses and eyelid scrubs, which help to remove debris and crusting. These measures combined can often provide symptomatic relief and clear up the condition effectively.

Other treatments, such as topical steroids, systemic antibiotics, or oral antivirals, are not the first-line approaches for this condition. Topical steroids may be used in severe cases for inflammation but are not the foundation of treatment. Systemic antibiotics are reserved for more generalized or severe cases not responding to topical therapies. Oral antivirals have no role in blepharitis as it is not a viral condition. Therefore, topical erythromycin stands out as the most appropriate and effective initial treatment for blepharitis.