Blepharitis is an inflammatory dis- ease of the eyelids, and associated with redness, itching, burning, tear- ing, and crusting of the lids. e eyelids may be sensitive to the touch. It may be caused by the bac- teria living on our skin, underly- ing skin conditions like seborrhea and rosacea, and dysfunction of the meibomian oil glands of the eyelid. In many patients, any combination of these three factors may coexist and contribute to blepharitis. Blepharitis is oſten undiagnosed and untreated. Since some of the symptoms of blepharitis such as dryness, irritation, and tearing, are similar to dry eye syndrome, pa- tients are oſten mistakenly treated with artificial tears and lubricants, which won’t treat the underlying causes of blepharitis. A thorough examination of the eyelids and lashes is critical for arriving at the correct diagnosis and treatment plan for blepharitis. In addition, it is a well-known phenomenon that blepharitis can exacerbate dry eye syndrome. For decades, the traditional ap- proach to treating blepharitis has been warm compresses, and lid scrubs with dilute baby shampoo. is regimen is frequently not effec- tive and at times the baby shampoo can be irritating to the eyelid skin and ocular surface and actually make patients feel worse. I have developed a new approach to blepharitis treatment utilizing Avenova, a commercially available solution that is quick and easy to use. Avenova utilizes Neutrox, a pure 0.01% concentration of hypo- chlorous acid in saline. While acid on your eyes may sound frighten- ing, the Neutrox acid is completely safe, and is the same bacteria-kill- ing component found in the white blood cells in our own immune system. When the body’s own de- fenses are overwhelmed and the eye lid infection and irritation persist, the scientifically engineered formu- lation found in Avenova is an ef- fective solution to cleanse, remove, and protect against the bacteria that are oſten a major cause of the symp- toms of blepharitis. Packaged in a glass bottle with a spray top and dispensed onto a cot- ton pad or cotton ball, the solution actually cleans the lashes and eye- lid skin. It is non-toxic to human tissues and non-irritating. Ave- nova may be used twice a day, in the morning and at bedtime. Baby shampoo lid scrubs involve prepa- ration of a dilute solution of baby shampoo, and the skillful use of a Q-tip or cotton applicator near the eye. Other commercially available eyelid scrub pads are conveniently packaged and ready to use, but their therapeutic solutions can be irritat- ing to the eyelid and ocular surface. I have recently treated a 65 year old retired physician who was re- ferred to me aſter failing two years of treatment for dry eye syndrome Spring 2015 One of the most common ocular complaints I hear from my patients is of ocular irritation and burning. Quite frequently, blepharitis is the cause of these symptoms, and of- ten this condition has been undi- agnosed or under-treated. I have recently come across a new product called Avenova that seems to be an extremely effective and well toler- ated treatment for these conditions. Blepharitis is one of the most com- mon conditions prompting a visit to an ophthalmologist’s or optom- etrist’s office, and it is estimated to affect up to 23 million people in our country and be present in up to 30% of the patients seen by eye care prac- titioners. As a Cornea and External Disease specialist, I am constantly referred patients with longstanding and severe dry eye disease, blepha- ritis, and ocular surface disease. Next Page Steven I. Rosenfeld, MD, FACS “SEARCH FOR THE MAGIC BULLET”