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Pediatric blepharokeratoconjunctivitis: review of epidemiology, pathophysiology, and current treatments

Rija Awan1, Shama Khan2, Wajid Ali Khan2

  • 1University of Michigan Medical School, Ann Arbor, Michigan, USA.

Current Opinion in Ophthalmology
|April 25, 2025
PubMed

Insights

Pediatric blepharokeratoconjunctivitis (BKC) is a chronic eye condition often underdiagnosed. Integrated management approaches achieve high remission rates, with new treatments like lotilaner offering improved efficacy.

Area of Science:

  • Ophthalmology
  • Pediatric Eye Care

Background:

  • Pediatric blepharokeratoconjunctivitis (BKC) is a chronic inflammatory condition affecting the eyelids, conjunctiva, and cornea.
  • It is frequently underdiagnosed and can lead to vision-threatening complications.

Purpose of the Study:

  • To offer a comprehensive review of pediatric BKC epidemiology and clinical characteristics.
  • To explore the underlying pathophysiology and assess emerging therapeutic strategies for BKC.

Main Methods:

  • Literature review of epidemiological data, clinical features, pathophysiology, and treatment strategies for pediatric BKC.
  • Analysis of recent clinical evidence and FDA-approved treatments.

Main Results:

  • Remission rates of approximately 95% are achievable with integrated management, including antibiotics, corticosteroids, immunosuppressants, and lid hygiene.
  • The FDA has approved 0.25% lotilaner ophthalmic solution for Demodex blepharitis, showing safety and efficacy with twice-daily application over six weeks.

Conclusions:

  • Pediatric BKC is a chronic, recurrent condition requiring early diagnosis and patient education.
  • Standardized treatment protocols are lacking, highlighting the need for continued research to prevent severe visual outcomes.
Abstract

Keywords:
demodexmeiobian gland dysfunctionocular surface inflammationpediatric blepharokeratoconjunctivitis

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