Objective: Blepharokeratoconjunctivitis (BKC) is a disease characterized by inflammation of the eye lid, conjunctiva and cornea and is typically treated empirically with topical antibiotic/anti-inflammatory agents. The purpose of this study was to compare the cost-effectiveness of tobramycin 0.3%/loteprednol 0.5%, (Zylet) to tobramycin 0.3%/dexamethasone 0.1%, (Tobradex) for the rapid control of BKC. Methods: Effectiveness data for this analysis came from a randomized, double-masked, parallel-group study of forty patients with BKC. Patients were treated with either Zylet™ or Tobradex® administered twice daily in the test eye. The measure of effectiveness used was the change in a clinical composite score of four BKC components: blepharitis, ocular discharge, conjunctivitis, and corneal punctuate epithelial keratopathy (PEK). Each clinical component was graded on a scale of 0 (minimum) to three (extensive) and assessed at baseline and on day 4 (±1) of therapy. Five different pharmacy chains were surveyed as to their prices for a 5ml bottle of both Tobradex and Zylet. The average price of each agent was used as the cost measure in the analysis. A probabilistic sensitivity analysis evaluated the robustness of the economic outcomes. The economic perspective was that of the payer. Due to the short time span no cost discounting was performed. Results: Reductions in the BKC clinical composite scores at the day-4 assessment were calculated at 4.5 (SD±1.7) versus 7.1 (SD±1.2) for the Zylet and Tobradex groups, respectively. The average retail costs for Zylet and Tobradex were $96.45 (SD±$5.26) and $71.75 (SD±$5.48) respectively. The cost-effectiveness ratios for Zylet and Tobradex therapy were $21.43 and $10.10, respectively. The cost-effectiveness results remained consistent using the probabilistic sensitivity distributions tested. Conclusion: Tobradex economically dominated Zylet for the rapid control of BKC because it was both less costly and more effective.