Demodex Blepharitis Carries Significant Psychosocial Burden

Demodex blepharitis negatively impacts both daily activities and the mental and physical well-being of those diagnosed, according to a study in Clinical Ophthalmology. 

Researchers originally enrolled 311 patients (62.4% women, 37.6% men; mean age 68±13 years) with a diagnosis of Demodex blepharitis into a multicenter, observational, prospective study.

The diagnosis of Demodex blepharitis was based on the presence of at least 1 mite per lash (upper and lower eyelids combined), more than 10 collarettes on the upper lashes, and at least mild lid margin erythema of the upper eyelid in at least 1 eye.

All participants were asked to complete a questionnaire about their symptoms, daily activities, quality of life, and management approaches. Descriptive statistics were used to analyze their responses.

Investigators report more than half of the patients experienced symptoms of blepharitis for at least 4 years and the 3 most frequent and bothersome symptoms reported by patients were dry eyes, itchiness, and irritation. 

Demodex blepharitis negatively affected 80% of patients (N=296) on psychosocial metrics. Almost half of the patients (47%) responded that they were conscious of their eyes all day, and 23% said that they were constantly worrying about their eyes. They also reported difficulty driving at night (47%), additional time needed for daily hygiene routine (30%), and difficulty in wearing eye make-up (in 34% of women). 

Though all participants had clinical signs of Demodex blepharitis, 58% said they had never been previously diagnosed with blepharitis. 

81% of patients (N=300) said they had attempted various management approaches for their Demodex Blepharitis. Common management approaches included: artificial tears (47%), warm compresses (32%), and lid wipes (14%).

According to researchers, “Collarettes, the pathognomonic sign of Demodex blepharitis, can be easily identified by examining the upper lid margin and lash base when a patient looks down during a slit lamp examination. Widespread education is needed to ensure eye care providers check for collarettes at every eye examination as a simple and fast way of diagnosing Demodex blepharitis without adding chair time.” 

Study limitations include symptom overlap between Demodex blepharitis and dry eye disease.