Demodex blepharitis is a common disease of the eyelid, affecting approximately 25 million Americans. This article reviews what is known about the mechanisms and impact of Demodex blepharitis, risk factors, signs and symptoms, diagnostic techniques, current management options, and emerging treatments. Demodex mites contribute to blepharitis in several ways: direct mechanical damage, as a vector for bacteria, and by inducing hypersensitivity and inflammation. Risk factors for Demodex blepharitis include increasing age, rosacea, and diabetes. The costs, symptom burden, and psychosocial effects of Demodex blepharitis are considerable. The presence of collarettes is pathognomonic for Demodex blepharitis. Redness, dryness, discomfort, foreign body sensation, lash anomalies, and itching are also hallmarks of the disease. Although a number of oral, topical, eyelid hygiene and device-based options have been used clinically and evaluated in studies for the management of Demodex blepharitis, none have been FDA approved to treat the disease. Recent randomized controlled clinical trials suggest that lotilaner ophthalmic solution, 0.25%, is a topical treatment with the potential to eradicate Demodex mites and eliminate collarettes and eyelid redness for an extended period.
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http://dx.doi.org/10.1097/ICL.0000000000001003 | DOI Listing |
Indian J Ophthalmol
January 2025
Cornea, Cataract and Refractive Surgery, Darshan Eye Clinic and Surgical Centre, Chennai, Tamil Nadu, India.
Demodexblepharitis (DB) has become one of the common differential diagnoses in patients presenting with red eyes in daily clinics. In this review article, we have incorporated a detailed discussion about the mite and the various mechanisms by which it causes different signs and symptoms, the risk factors, and diagnostic methods with current and emerging treatment modalities. Because of the chronic symptoms and rather a late diagnosis, DB considerably affects patients' quality of life.
View Article and Find Full Text PDFCont Lens Anterior Eye
December 2024
Department of Ophthalmology, Molecular Pharmacology and Physiology, FL, United States; Pathology and Cell Biology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States.
Purpose: To evaluate the efficacy and safety of topical Ivermectin- Metronidazol in the management of demodex infestation and their effect in Meibomian gland dysfunction (MGD) METHODS: Fifty-four patients (108 eyes) with demodex diagnosis and Meibomian gland dysfunction received Ivermectin 0.3 %+Metronidazole 0.5 % gel in the night for 5 weeks.
View Article and Find Full Text PDFCornea
December 2024
Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel.
Purpose: To examine the safety and efficacy of combined treatment with topical ivermectin 1% and intense pulsed light (IPL) for dry eye disease (DED) secondary to demodex blepharitis.
Methods: A retrospective review of medical files of patients treated at a private clinic specializing in DED between November 2022 and February 2024 was performed. Sixty-one patients aged 18 years or older with DED because of demodex blepharitis, who received the IPL and ivermectin 1% combination therapy, were included.
Cont Lens Anterior Eye
November 2024
Xiamen University affiliated Xiamen Eye Center, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Fujian Engineering and Research Center of Eye Regenerative Medicine, Eye Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361005, China; Department of Ophthalmology, Xiang'an Hospital of Xiamen University, Xiamen, Fujian 361005, China; Department of Ophthalmology, The First Affiliated Hospital of University of South China, Hengyang, Hunan 421001, China. Electronic address:
Purpose: To explore the in vitro killing effect of water-soluble berberine and lipid-soluble niclosamide against ocular Demodex folliculorum.
Methods: Demodex with good vigor were collected from patients' eyelashes. These mites were randomly distributed into different groups with 20 mites in each group.
Transl Vis Sci Technol
November 2024
Department of Cornea & Ocular Surface Diseases, Wuhan Aier Hankou Eye Hospital, Wuhan, China.
Purpose: We aimed to evaluate the clinical efficacy of a combined treatment regimen involving terpinen-4-ol (T4O) and eyelid deep cleaning for managing Demodex blepharitis.
Methods: In this randomized, open-label trial, 40 patients diagnosed with Demodex blepharitis at the Cornea Specialty Clinic of Hankou Aier Eye Hospital were enrolled. Participants were randomly assigned to either a T4O or a combination treatment group.
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