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Demodex is a common small parasite in the human body, with a body length of about 150-350 μm and mainly found in human sebaceous glands and skin hair follicles.In recent years, numerous studies in dermatology and ophthalmology have shown that Demodex is related to the occurrence and development of rosacea, blepharitis and other diseases. Demodex blepharitis has become one of the clinical concerns. Demodex blepharitis is an inflammation in the skin of the eyelid margin caused by Demodex infection.In severe cases, cornea and conjunctiva can be involved, and vision can be affected. Demodex blepharitis is a widespread and easily overlooked disease.Up to 90% of patients with blepharitis are infected with Demodex, and the main pathogenic diagnostic methods are light microscopy and in vivo confocal microscopy.At present, the treatment of Demodex blepharitis is mainly to remove mites by metronidazole and tea tree oil etc.Its risk factors and pathogenesis are not fully understood yet.This article mainly summarized and analyzed the research progress on the risk factors for Demodex blepharitis and its possible pathogenesis at home and abroad in order to provide references for further research and clinical treatment.
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AIM: To investigate the efficacy of optimal pulse technology(OPT)in the treatment of demodex blepharitis and its influence on ocular surface function.METHODS: A retrospective study was conducted from February 2018 to October 2020. A total of 127 patients(254 eyes)with demodex blepharitis were assigned to the observation group and the control group according to the treatment method. The control group(63 patients, 126 eyes)were given conventional hot compress, eye cleansing and drug therapy. On this basis, the observation group(64 patients, 128 eyes)was treated with OPT. Both groups were given 6wk of continuous treatment. Demodex count, Marx's line scores, meibum character scores, ocular surface disease index(OSDI)scores, non-invasive tear break-up time(NIBUT), non-invasive tear meniscus height(NITMH)and lipid layer thickness(LLT)were compared between the two groups, and safety was evaluated.RESULTS: After 6wk of treatment, demodex count, Marx's line scores, meibum character scores and OSDI scores of the two groups decreased. NIBUT, NITMH and LLT increased. Meanwhile, demodex count, Marx's line scores, meibum character scores and OSDI scores of the observation group were significantly lower than those in the control group. NIBUT, NITMH and LLT were longer/larger than those in the control group(P<0.001). No obvious abnormality of intraocular pressure or conjunctival/corneal injury was observed in either group.CONCLUSION:OPT is effective and safe in the treatment of demodex blepharitis.
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Demodex is one of the most common parasites in the human body. It can be classified into demodex folliculorum and demodex brevis based on the parasitic sites. It is an opportunistic pathogenic microorganism, and clinical symptoms may not appear in part of infected people, but the parasite can cause multiple common ocular diseases represented by blepharitis. Its typical symptoms include dry eyes, foreign body sensation in eyes, secretion attached to eyelashes, and ocular surface irritation. The diagnosis of demodex blepharitis should be based on the clinical manifestations and the results of etiological tests. The treatment is related to many kinds of drugs including plant essential oil and physical therapy. At present, diagnosing and treating demodex blepharitis is increasingly sophisticated, but the relationship between demodex infection and its pathogenicity remains unclear. This paper summarizes the current characteristics of demodex and the clinical manifestation, diagnosis, treatment, and existing issues of demodex blepharitis, hoping to provide a reference for future studies in demodex.
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@#AIM: To analyze the effectiveness and safety of different concentrations of tea tree essential oil in the treatment of Demodex blepharitis. <p>METHODS: The clinical data of 120 patients(240 eyes)with blepharitis caused by Demodex infection in our hospital from June 2017 to June 2019 were retrospectively analyzed. According to the use of tea tree essential oil concentrations of 10%, 15%, 20% and 25%, patients were divided into 4 groups(group A, group B, group C, group D), each group with 30 people. All patients were given meibomian gland massage, eyelid margin cleaning, and then scrubbed with different concentrations of tea tree oil to clean the eyelid margin. The number of demodex mites, clinical symptom score, clinical sign score, tear film break-up time(BUT), corneal fluorescein staining(FL)and SchirmerⅠtest(SⅠt)were compared before and 2, 4wk after treatment.<p>RESULTS: The number of Demodex mites, clinical symptom score, clinical sign score, BUT, FL and SⅠt were not statistically significant in the four groups before treatment(<i>P</i>>0.05). After treatment, the number of Dmodex mites, clinical symptom score, and clinical sign score in each group were lower than those before treatment, and the number of Demodex mites, clinical symptom score, and clinical sign score after 4wk of treatment in each group were lower than those after 2wk of treatment(all <i>P</i><0.008). After 2 and 4wk of treatment, the number, clinical symptom score and clinical signs score of Demodex mites in group A were the highest, while those in group D were the lowest(all <i>P</i><0.008). After treatment, the BUT of each group was higher than before treatment, and reached the peak in the 4wk. After 2 and 4wk of treatment, BUT among groups was highest in group D and lowest in group A(all <i>P</i><0.008). After treatment, FL and S I t of each group were lower than before treatment, and reached the lowest value in the 4wk. After 2 and 4wk of treatment, FL among the groups was the lowest in group D and the highest in group A(all <i>P</i><0.008). <p>CONCLUSION: Compared with 10% tea tree essential oil, 15% tea tree essential oil can effectively repel mites, relieve clinical symptoms and eye signs in patients with Demodex blepharitis, and is safer than 20% and 25% tea tree essential oils. As the preferred concentration of tea tree essential oil against Demodex blepharitis.
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@#AIM: To investigate the clinical effect of tea tree oil eye patch combined with eyelid margin deep cleaning device in treating demodex blepharitis.<p>METHODS: This was a prospective, randomized and self-controlled study. Thirty-two patients(sixty-four eyes)diagnosed in demodex blepharitis were enrolled in the study. We randomly assigned one eye of the participants to the study group, which received tea tree oil eye patch once a day combined with monthly eyelid margin deep cleaning, and the other eye to the control group, which received tea tree oil eye patch therapy only. OSDI score of each subject, demodex mite counts, eyelid margin cleanness degree, eyelid margin abnormal score, non-invasive tear break-up time-first, tear meniscus height, redness, meibography score and Schirmer I test of each eye were evaluated before, and three months after the treatment. <p>RESULTS: Three months after treatment, demodex mite counts in both groups were significantly decreased(<i>P</i><0.05), the counts were lower in the study group(<i>P</i><0.05). Significant improvements were observed in the eyelid margin cleanness degree of the two groups(<i>P</i><0.05), and the degree was lower in the study group(<i>P</i><0.05). The OSDI score decreased significantly after treatment(<i>P</i><0.05). The NITBUT-first, redness and FL of the study group were significantly improved after treatment(<i>P</i><0.05), and the redness and FL of the control group were significantly improved after treatment(<i>P</i><0.05), NITBUT-first was longer after treatment but there was no statistical difference. The tear film parameters were no significant differences between the two groups. No significant changes were found in tear meniscus height, Schirmer I test and meibomian gland loss score after treatment. No obvious complications were observed in the study.<p>CONCLUSION: Tea tree oil eye patch therapy is effective in treating demodex blepharitis. With eyelid margin deep cleaning device combining, can further strengthen the efficacy of tea tree oil in eliminating mites and cylindrical cuffs, maintain the eyelid margin cleanness, and improve the abnormality of eyelid margin, which is a convenient,effective and safe treatment for demodex blepharitis.
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Blepharitis is one of the common eye diseases,it may cause ocular irritation symptoms,and even cause damage of visual function,if it involves the meibomian gland and cornea.Recent studies have shown that Demodex infestation may be an important but under-estimated cause of blepharitis,its diagnosis and treatment become the focus of blepharitis research,clinical doctors should pay adequate attention to this.Demodex blepharitis still faces many uncertain problems and challenges.In this paper,the controversial problems of Demodex blepharitis diagnosis and treatment,combined with domestic and foreign research results and the author's experience was analyzed,and we also discussed that how to improve the accuracy of clinical diagnosis and improve the treatment effect of Demodex blepharitis.Herein,we emphasize on the diagnosis and treatment options of Demodex blepharitis.Early detection of the pathogen and prompt treatment would ultimately improve the prognosis of Demodex blepharitis.
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PURPOSE: To evaluate the treatment efficacy of polyhexamethylene biguanide (PHMB) lid scrub on Demodex blepharitis. METHODS: Thirty-one patients diagnosed with Demodex blepharitis were evaluated every 2 weeks during 8 weeks of lid scrub treatment with 0.4% PHMB. Patients underwent epilation of 4 eyelashes in each eye, and the number of Demodex lesions was counted. The patients answered questionnaires regarding ocular surface discomfort and underwent ophthalmologic exams including slit lamp and tear breakup time (TBUT). Compliance was recorded as 1 of 3 stages (good, moderate, poor). RESULTS: One patient was excluded for poor compliance. After PHMB lid scrub for 8 weeks, Demodex count was reduced in 28 of 30 patients (pre-PHMB 7.9 +/- 3.6 counts, post-PHMB 2.2 +/- 2.4 counts, p < 0.01). In addition, TBUT showed a statistically significant increase after PHMB lid scrub (pre-PHMB 2.7 +/- 0.8 seconds, post-PHMB 3.4 +/- 0.9 seconds, p < 0.01). Ocular surface disease index (OSDI) score was reduced in 28 of 30 patients (pre-PHMB 22.0 +/- 10.7 points, post-PHMB 7.4 +/- 6.0 points, p < 0.01). CONCLUSIONS: Eight weeks of treatment with polyhexamethylene biguanide lid scrub on Demodex blepharitis had good treatment efficacy for reducing Demodex counts and OSDI scores and increasing TBUT.
Subject(s)
Humans , Blepharitis , Compliance , Eyelashes , Hair Removal , Surveys and Questionnaires , Tears , Treatment OutcomeABSTRACT
PURPOSE: To report a case of corneal opacity improved by treatment of demodex blepharitis. CASE SUMMARY: A 50-year-old female who received sub-laser-assisted in situ keratomileusis (LASIK) flap surgery was referred to our clinic with corneal opacity and neovascularization in her left eye. Her visual acuity was 0.5. Telangiectasis of the eyelid margin and meibomian gland dysfunction were observed. Seven Demodex folliculorum were found in 4 eyelashes of the left eye. Lid scrub with 0.4% polyhexamethylene biguanide (PHMB) and ointment containing dexamethasone was started for demodex blepharitis treatment. After 6 months of treatment, the number of Demodex folliculorum was decreased to 2 and the best corrected visual acuity was 0.8. Corneal opacity and neovascularization were also improved. CONCLUSIONS: The present study showed that demodex blepharitis can induce atypical corneal opacity and neovascularization after LASIK surgery. Evaluation and treatment of demodex blepharitis in these patients is important.