Establishing a consensus for the diagnosis and treatment of Demodex blepharitis

As part of our research spotlight series, which aims to highlight interesting pieces of optometry related research, Drs Nikhil Sharma and Eilidh Martin describe findings from a recently published Delphi study which sought to establish consensus on best practice for the diagnosis and treatment of Demodex blepharitis

Figure 1: Algorithm for clinical diagnosis of Demodex blepharitis

Two species of demodex mites, ie Demodex folliculorum and Demodex brevis, have been reported to be found in humans. The former lives in eyelash follicles and the latter burrows deep inside the meibomian glands.

Demodex mites have been implicated in causing various ocular diseases such as anterior and posterior blepharitis, blepharokeratoconjunctivitis, and are a comorbidity in dry eye disease (DED) and meibomian gland dysfunction (MGD).

The signs and symptoms of Demodex blepharitis overlap with DED and MGD. Additionally, the mere presence of Demodex may not be a reliable indicator of the disease since demodex is also found in healthy individuals.

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