The Efficacy of Kohl (Surma) and Erythromycin in Treatment of Blepharitis: An Open-Label Clinical Trial

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.