Demodex Blepharitis: A Comprehensive Review of the Disease, Current Management, and Emerging Therapies.

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Department of Ophthalmology (M.K.R.), Icahn School of Medicine, Mt. Sinai, NY; Virginia Eye Consultants (E.Y.), Norfolk, VA; University of California (M.B.), Davis Eye Center, Sacramento, CA; Sidney Kimmel Medical College at Thomas Jefferson University (C.J.R.), Philadelphia, PA; University of Pittsburgh School of Medicine (D.K.D.), Pittsburgh, PA; University of Alabama at Birmingham School of Optometry (K.K.N.), Birmingham, AL; Kentucky College of Optometry (P.K.), University of Pikeville, Pikeville, KY; Kentucky Eye Institute (P.K.), Lexington, KY; Scripps Clinic Medical Group (F.S.M.), La Jolla, CA; Tarsus Pharmaceuticals (A.C., J.M.), Irvine, CA; and Gaddie Eye Centers (I.B.G.), Louisville, KY.

Published: August 2023

AI Article Synopsis

  • Demodex blepharitis is a common eyelid disease affecting about 25 million Americans, caused by Demodex mites that can lead to mechanical damage, bacterial infection, and inflammation.
  • Risk factors include older age, rosacea, and diabetes, with symptoms like redness, dryness, discomfort, and the presence of collarettes, which are indicative of the condition.
  • Multiple management options exist, but none are FDA approved; however, a recent clinical trial suggests that lotilaner ophthalmic solution could effectively treat the disease by eradicating the Demodex mites and reducing symptoms.

Article Abstract

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://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351901PMC
http://dx.doi.org/10.1097/ICL.0000000000001003DOI Listing

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