This study reports the results of a Delphi consensus method to develop a pragmatic approach to BKC treatment in children. A major limitation to the study was the involvement of only four clinicians. Four rounds in total were completed to gather consensus. Round 1 considered disease severity and treatment options. Round 2 considered indications and dosages of treatment modalities. Round 3 considered refinement of agreement on treatment decisions and round 4 combined all responses into one summary diagram. The consensus process addressed eyelid, corneal and conjunctival disease features. Treatment was targeted towards specific findings rather than to the overall disease severity. Agreement was not reached for the role of dietary modification, typical lubricants and preference for oral or topical antibiotics.