Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 1;40(8):995-1001.
doi: 10.1097/ICO.0000000000002542.

Prevalence of Ocular Demodicosis in an Older Population and Its Association With Symptoms and Signs of Dry Eye

Anny Mansim Cheng  1   2   3 , Jodi Hwang  1   4 , Harrison Dermer  1   4 , Anat Galor  1   4
Affiliations

Prevalence of Ocular Demodicosis in an Older Population and Its Association With Symptoms and Signs of Dry Eye

Anny Mansim Cheng et al. Cornea. .

Abstract

Purpose: To evaluate associations between Demodex and its symptoms and ocular surface parameters in individuals with dry eye (DE).

Methods: A cross-sectional study of 119 individuals with DE symptoms or signs, grouped by the presence of ocular demodicosis, was performed. All individuals filled out questionnaires and underwent an ocular surface examination. Demographics, comorbidities, symptoms profiles, and ocular surface parameters were compared between the 2 groups. Multivariable regression analyses were used to determine which factors were associated with DE symptoms. Receiver operating curves analyses were performed to evaluate relationships between Demodex quantity and specific clinical phenotypes.

Results: Demodex was highly prevalent in our population (68.9%) with average counts of 4.2 ± 3.9. Individuals with and without Demodex had comparable demographics. Overall, symptoms profiles were similar between individuals with and without Demodex using the Dry Eye Questionnaire 5 and Ocular Surface Disease Index. Individuals with Demodex, however, were more likely to report itching (58.5% vs. 35.1%, P = 0.03), with increasing frequency in those with higher Demodex counts. Individuals with Demodex also had more severe eyelid abnormalities [cylindrical dandruff (CD) and lid vascularity] and a more unstable tear film but similar tear production and corneal staining when compared with individuals without Demodex. Neither Demodex nor ocular surface findings related to DE symptoms in multivariable analyses. Receiver operating curves analysis revealed Demodex counts ≥2 maximized sensitivity and specificity for both itching (64.7% and 59.0%, respectively) and CD (80.4% and 60.4%, respectively).

Conclusions: Demodex is highly prevalent in an older population with DE. Symptom of itching and CD were the findings most specific for Demodex.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

References

    1. Rufli T, Mumcuoglu Y. The hair follicle mites Demodex folliculorum and Demodex brevis: biology and medical importance. A review. Dermatologica. 1981;162(1):1–11. - PubMed
    1. Sedzikowska A, Oseka M, Skopinski P. The impact of age, sex, blepharitis, rosacea and rheumatoid arthritis on Demodex mite infection. Arch Med Sci. 2018;14(2):353–356. - PMC - PubMed
    1. Vargas-Arzola J, Segura-Salvador A, Torres-Aguilar H, et al. Prevalence and risk factors to Demodex folliculorum infection in eyelash follicles from a university population of Mexico. Acta Microbiol Immunol Hung. 2020:1–5. - PubMed
    1. Kabatas N, Dogan AS, Kabatas EU, et al. The Effect of Demodex Infestation on Blepharitis and the Ocular Symptoms. Eye Contact Lens. 2017;43(1):64–67. - PubMed
    1. Erbagci Z, Erbagci I, Erkilic S. High incidence of demodicidosis in eyelid basal cell carcinomas. Int J Dermatol. 2003;42(7):567–571. - PubMed

MeSH terms