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Pathophysiology of Demodex Blepharitis

Opinion
Video

Elizabeth Yeu, MD, discusses complications that may arise from inadequate treatment of Demodex blepharitis.

This is a video synopsis/summary of a discussion involving Elizabeth Yeu, MD. Dr Yeu discusses Demodex blepharitis, a type of eyelid inflammation caused by an overgrowth of demodex mites in the eyelash follicles. She states that the disease is very common, affecting 50-70% of patients on any given day. The pathognomonic sign is waxy debris extruding from the lash follicles, which is easily visible on downward gaze when patients look down to adjust their masks. However, on forward gaze the debris can be missed. If abundant enough, demodex blepharitis causes lid erythema (redness) with missing lashes. Patients may report symptoms like itching, dry eyes, foreign body sensation, excessive tearing, or mattering, especially upon awakening. Dr Yeu sees demodex blepharitis most often in her older cataract surgery patients but also in her laser-assisted in LASIK patients. She notes that contact lens intolerance can be associated with demodex blepharitis. In summary, demodex blepharitis is a very prevalent eyelid inflammatory condition caused by demodex mites. It is often asymptomatic but can cause ocular symptoms and impact contact lens tolerance or cataract surgery outcomes if not properly treated. Careful slit lamp exam, especially on downward gaze, is needed to catch this progressive disease.

Video synopsis is AI-generated and reviewed by AJMC editorial staff.

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