Which of the following is NOT typically included in initial blepharitis management?

• A. Lid scrubs
• B. Hypochlorous acid spray
• C. Omega-3 diet
• D. Oral antibiotics

Answer: (D)

In initial blepharitis management, the focus is on reducing eyelid inflammation and bacterial load with lid-focused care. Start with consistent lid hygiene using lid scrubs to physically remove crusts and bacteria, along with warm compresses to soften secretions and aid gland drainage. A hypochlorous acid spray is a convenient, gentle antiseptic adjunct that helps keep the lid margins cleaner. Omega-3 fatty acids are often recommended as an adjunct to support meibomian gland function and tear film stability, making them a reasonable addition to initial care for many patients.

Oral antibiotics are not typically used at this stage because they involve systemic treatment and are generally reserved for more persistent or refractory cases, especially when there is significant meibomian gland dysfunction or rosacea that does not respond to initial lid hygiene and topical measures.