Demodex and the eye - A review

Abstract

Demodexblepharitis (DB) has become one of the common differential diagnoses in patients presenting with red eyes in daily clinics. In this review article, we have incorporated a detailed discussion about the mite and the various mechanisms by which it causes different signs and symptoms, the risk factors, and diagnostic methods with current and emerging treatment modalities. Because of the chronic symptoms and rather a late diagnosis, DB considerably affects patients' quality of life. The clues to identify cylindrical dandruff, the diagnostic sign of Demodex, visualization of the mite correlating their presence with signs and symptoms, and instituting early and appropriate treatment are the goals of this article.

Figure 1

(a) Cylindrical dandruff in lashes. (b) Typical sleeve at the base of eyelash

Figure 2

Demodex folluculorum under microscope (10x)

Figure 3

(a) Superficial vascularisation in the superior cornea. (b) Diffuse inflammation with peripheral corneal infiltrates

Figure 4

(a) Lower-lid chalazion with inferior bulbar congestion and sterile corneal Infiltrate. (b) Irregular fluorescein stain pattern of the inferior cornea

Figure 5

(a–c) Typical staphylococcal collarettes near the tip of eyelashes

Figure 6

(a) Lower-lid chalazion with inferior bulbar congestion and sterile corneal infiltrate. (b) Blocked meibomian gland in meibography corresponding to the site of chalazion