Interview with Mile Brujic, OD: Exploring Demodex Blepharitis From a Clinical Perspective

Demodex blepharitis presents with a wide variety of symptoms, which can range in severity from mild to more severe. The classic symptoms include itching along the lash and eyelid margins, diffuse eye discomfort, and fluctuating vision. Secondary meibomian gland dysfunction can further complicate the condition. Patients may also develop internal or external hordeola (styes), which can lead to chalazia, which are eyelid bumps caused by hardened oil deposits in the glands.

The primary issue with Demodex blepharitis is the overpopulation of mites in the hair follicles on the lashes, creating collarettes or scurf around the lash base. The mites can obstruct meibomian glands, causing symptoms similar to dry eye. To diagnose Demodex blepharitis, the clinician should observe the lid margin through a slit lamp at high magnification to look for fine collarettes at the base of the lashes.

Treating Demodex blepharitis has historically been challenging, with recommended treatments like hypochlorous spray, lid hygiene, warm compresses, and tea tree oil wipes providing limited relief. However, the introduction of lotilaner 0.25% ophthalmic solution offers an effective treatment option that alleviates symptoms and improves patient outcomes.

The prevalence of Demodex blepharitis was evaluated in the Tratler study, which revealed that approximately 57% to 58% of patients visiting eye care clinics have Demodex blepharitis, which is higher than previously thought. The high prevalence of Demodex blepharitis necessitates a change in clinical behavior to identify and treat affected patients.

This summary was AI-generated and reviewed by an AJMC editor.

For other articles and videos in this AJMC® Perspectives publication, please visit “Updates in the Management of Demodex Blepharitis”