title: Ocular demodicosis as a potential cause of pediatric blepharoconjunctivitis.
abstract: OBJECTIVE
  To report Demodex infestation in pediatric blepharoconjunctivitis.
  
  
  METHODS
  A retrospective review of 12 patients, with ages from 2.5-11 years, with chronic blepharoconjunctivitis who failed to respond to conventional treatments. Demodex was detected by lash sampling and microscopic examination. Patients were treated with 50% tea tree oil (TTO) eyelid scrubs or 5% TTO ointment eyelid massages for 4-6 weeks.
  
  
  RESULTS
  Demodex mites were found in all, but 1 case had cylindrical dandruff in the lashes. After 1 week of TTO treatment, all patients showed dramatic resolution of ocular irritation and inflammation while Demodex counts dropped. All corneal signs resolved within 2 weeks except for a residual anterior stromal scar in 1 eye. During a follow-up period of 8.3 ± 4.6 months, 1 patient showed recurrent inflammation, which was successfully managed by a second round of TTO treatment.
  
  
  CONCLUSIONS
  Demodicosis should be considered as a potential cause of pediatric refractory blepharoconjunctivitis. Eyelid scrubs or massage with TTO could be an effective treatment regimen in these cases.
authors.affiliation: Ocular Surface Center, Miami, FL 33173, USA.
authors.forename: Lingyi
authors.initials: L
authors.lastname: Liang
authors.forename: Steve
authors.initials: S
authors.lastname: Safran
authors.forename: Yingying
authors.initials: Y
authors.lastname: Gao
authors.forename: Hosam
authors.initials: H
authors.lastname: Sheha
authors.forename: V K
authors.initials: VK
authors.lastname: Raju
authors.forename: Scheffer C G
authors.initials: SC
authors.lastname: Tseng
mesh_terms: D000818:Animals; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D001762:Blepharitis / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003231:Conjunctivitis / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D015822:Eye Infections, Parasitic / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D005140:Eyelashes / Q000469:parasitology; D005260:Female; D006801:Humans; D008297:Male; D008405:Massage; D008924:Mite Infestations / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D008925:Mites / Q000472:pathogenicity; D012189:Retrospective Studies; D020947:Tea Tree Oil / Q000627:therapeutic use
chemical_list: D000891:Anti-Infective Agents, Local; D020947:Tea Tree Oil