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This article highlights the importance of recognizing blepharokeratoconjunctivitis (BKC) in children and reviews the clinical characteristics and current therapeutic modalities.The mainstay of BKC treatment remains controlling the meibomian gland inflammation and treating cobormid conditions. BKC can occur in the setting of ocular rosacea and Demodex infestation. Small studies have shown treatment benefits of topical cyclosporine A as well as oral azithromycin in pediatric BKC.BKC is a cause for visual loss in children, and therefore pediatric ophthalmologists should be more vigilant about early diagnosis and long-term treatment. There is a lack of randomized controlled trials on this topic and no standardized outcome measures. Better ways to measure the clinical outcome of various treatment modalities need to be developed.