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Pathogenic role of Demodex mites in blepharitis

Liu, Jingbo; Sheha, Hosam; Tseng, Scheffer CG

Current Opinion in Allergy and Clinical Immunology: October 2010 - Volume 10 - Issue 5 - p 505–510
doi: 10.1097/ACI.0b013e32833df9f4
Eye allergy: Edited by Leonard Bielory and Stefano Bonini
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Purpose of review To summarize the key literature and our research experience regarding Demodex infestation as a potential cause of ocular inflammatory diseases with a special emphasis on Demodex blepharitis.

Recent findings Two distinct Demodex species have been confirmed as a cause of blepharitis: Demodex folliculorum can cause anterior blepharitis associated with disorders of eyelashes, and D. brevis can cause posterior blepharitis with meibomian gland dysfunction and keratoconjunctivitis. Tea tree oil treatments with either 50% lid scrubs or 5% lid massages are effective in eradicating mites and reducing ocular surface inflammation.

Summary Demodex blepharitis is a common but overlooked external eye disease. The pathogenesis of Demodex blepharitis in eliciting ocular surface inflammation has been further clarified. The modified eyelash sampling and counting method makes it easier and more accurate to diagnose Demodex infestation. Tea tree oil shows promising potential to treat Demodex blepharitis by reducing Demodex counts with additional antibacterial, antifungal, and anti-inflammatory actions.

aOcular Surface Center, and Ocular Surface Research & Education Foundation, Miami, Florida, USA

bEye Hospital, Wenzhou Medical College, Wenzhou, Zhejiang, China

Correspondence to Scheffer C.G. Tseng, MD, PhD, Ocular Surface Center, 7000 SW 97 Avenue, Suite 213, Miami, FL 33173, USA Tel: +1 305 274 1299; fax: +1 305 274 1297; e-mail: stseng@ocularsurface.com

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