Abstract
Introduction Blepharitis is a common and chronic form of eyelid inflammation. Blepharitis treatment aims to decrease symptoms through antibacterial effects. One of the most common treatments of eyelid diseases in traditional medicine is using kohl. This clinical trial aimed to investigate its efficacy as a complementary treatment in staphylococcal blepharitis through an open-label clinical trial. Materials and Methods Thirty patients were randomized to receive kohl in one eye contralateral and erythromycin ointment in another eye for 90 days. At baseline and after 90 days of treatment, symptoms, clinical signs, and side effects of treatments were recorded. Statistical analysis was carried out using SPSS software, version 19. Results Despite randomization, there was a significant difference between the intervention and control eyes in the baseline mean clinical score (intervention eye: 9.86 (2.95) and control eye: 4.30 (2.81), P < 0.001). The degree of reduction of related signs and symptoms in the eyes treated with kohl was significantly higher than that in the control group: (5.2 vs. 2.20, P < 0.001) for symptoms and (7.40 vs. 2.46, P < 0.001) for clinical signs. Cohen's d statistic for mean difference of sign and symptom was 2.4 and 1.75, respectively, indicating a very strong effect. Conclusion The present study results demonstrated a significant improvement in blepharitis-related signs and symptoms. The degree of improvement in the eyes treated with kohl was much higher than that in the control eyes.
Highlights
Blepharitis is a common and chronic form of eyelid inflammation
After 90 days of treatment, the patient’s signs and symptoms in both treatment groups significantly improved compared to baseline. Both symptom and sign scores at follow-up sessions among the eyes treated with erythromycin were lower than those in the eyes treated with kohl
Erefore, we compared the degree of improvement in each group as the outcome measure. e degree of reduction of related signs and symptoms in the eyes treated with kohl was significantly higher than the control group (5.2 vs. 2.2) (P < 0.001) for symptoms and (7.4 vs. 2.46) (P < 0.001) for clinical signs (Table 2)
Summary
Blepharitis is one of the most common eye diseases that an ophthalmologist faces in the clinic. e etiology of blepharitis is not completely determined yet, but bacteria overload and the inflammation due to a load of bacteria have a significant role in developing the disease. Clinical findings, based on the type of blepharitis, include collarets around eyelashes, lids’ margin thickening and hyperemia, eyelash loss and misdirection and depigmentation, telangiectasia, lid margin irregularities and hypertrophy, and pouting and plugging of meibomian gland orifices that can be resulted in complications such as marginal ulceration of cornea, conjunctival or corneal phlyctenulosis. E most crucial symptom of staphylococcal blepharitis is eye burning and irritation in the morning due to the accumulation of microbial toxins on the cornea during sleep. One of the most common treatments of eyelid diseases in Persian medicine texts is using kohl. Considering the mentioned points about kohl efficacy in treating ocular infections based on Ancient Persian medicine texts, we aimed to compare kohl efficacy and safety in a clinical trial with ocular erythromycin in blepharitis treatment
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