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Treatment of Ocular Itching Associated With Ocular Demodicosis by 5% Tea Tree Oil Ointment

Gao, Ying-Ying MD; Xu, Duan-lian MD; Huang, li-Juan MD; Wang, Rong MD; Tseng, Scheffer C G MD, PhD

doi: 10.1097/ICO.0b013e31820ce56c
Clinical Science

Purpose: To determine whether ocular itching associated with ocular demodicosis can be treated by lid massage with 5% tea tree oil ointment (TTOO).

Methods: Twenty-four patients with ocular itching and ocular Demodex were treated with chlortetracycline hydrochloride eye ointment lid massage for 4 weeks and then treatment was switched to TTOO for another 4 weeks. They were examined every 2 weeks and their itching was graded as 0 (none), 1 (mild), 2 (moderate), or 3 (severe). Changes of itching scores and Demodex counts were compared.

Results: Before the treatment, all 24 patients reported itching graded as 1 (n = 3), 2 (n = 15), and 3 (n = 6) for a period of 2 weeks to 2 years despite previous topical antibiotics, antiinflammatory medications, or antiallergy medications. Demodex counts per 8 epilated lashes were 5.5 ± 1.6 for all patients but 4.6 ± 1.5, 4.8 ± 1.9, and 7.1 ± 2.1 for patients with grade 1, grade 2, and grade 3 itchiness, respectively (P < 0.05 between grade 2 and grade 3). After 4 weeks of chlortetracycline hydrochloride eye ointment treatment, little changes were observed regarding itching and Demodex counts in all patients (P > 0.05). In contrast, after 5% TTOO treatment, 16 patients were totally free of itching and the remaining 8 patients had different degrees of relief (P < 0.01). The Demodex count decreased to 0.7 ± 0.8 for total (P < 0.01).

Conclusions: There is a strong correlation between ocular itching and Demodex infestation and between symptomatic resolution and reduction of Demodex counts by daily lid massage with 5% TTOO.

From the *Department of Ophthalmology, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China; and †Ocular Surface Center, Miami, FL.

Received for publication August 7, 2010; revision received December 3, 2010; accepted December 12, 2010.

Supported by a grant from Natural Science Foundation of Fujian Province of China (No. 2006J0337).

Proprietary interest: Drs S. C. G. Tseng and Y -Y. Gao have filed a patent on the use of tea tree oil for the treatment of demodicosis.

Reprints: Ying-Ying Gao, Department of Ophthalmology, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China 362000 (e-mail:

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