Pathogenic role of Demodex mites in blepharitis.
OBJECTIVE
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.


RESULTS
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.


CONCLUSIONS
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.
Liu
Jingbo
J
Ocular Surface Center, and Ocular Surface Research & Education Foundation, Miami, Florida 33173, USA.
Sheha
Hosam
H
Tseng
Scheffer C G
SC
D000818:Animals; D001762:Blepharitis / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D003228:Conjunctiva / Q000276:immunology*; D005140:Eyelashes / Q000473:pathology; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D007249:Inflammation; D007637:Keratoconjunctivitis; D008537:Meibomian Glands / Q000473:pathology; D008924:Mite Infestations / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D008925:Mites / Q000276:immunology*; D020947:Tea Tree Oil / Q000627:therapeutic use
D020947:Tea Tree Oil