title: Treatment of ocular itching associated with ocular demodicosis by 5% tea tree oil ointment.
abstract: OBJECTIVE
  To determine whether ocular itching associated with ocular demodicosis can be treated by lid massage with 5% tea tree oil ointment (TTOO).
  
  
  METHODS
  Twenty-four patients with ocular itching and ocular Demodex were treated with chlortetracycline hydrochloride eye ointment lid massage for 4 weeks and then treatment was switched to TTOO for another 4 weeks. They were examined every 2 weeks and their itching was graded as 0 (none), 1 (mild), 2 (moderate), or 3 (severe). Changes of itching scores and Demodex counts were compared.
  
  
  RESULTS
  Before the treatment, all 24 patients reported itching graded as 1 (n = 3), 2 (n = 15), and 3 (n = 6) for a period of 2 weeks to 2 years despite previous topical antibiotics, antiinflammatory medications, or antiallergy medications. Demodex counts per 8 epilated lashes were 5.5 ± 1.6 for all patients but 4.6 ± 1.5, 4.8 ± 1.9, and 7.1 ± 2.1 for patients with grade 1, grade 2, and grade 3 itchiness, respectively (P < 0.05 between grade 2 and grade 3). After 4 weeks of chlortetracycline hydrochloride eye ointment treatment, little changes were observed regarding itching and Demodex counts in all patients (P > 0.05). In contrast, after 5% TTOO treatment, 16 patients were totally free of itching and the remaining 8 patients had different degrees of relief (P < 0.01). The Demodex count decreased to 0.7 ± 0.8 for total (P < 0.01).
  
  
  CONCLUSIONS
  There is a strong correlation between ocular itching and Demodex infestation and between symptomatic resolution and reduction of Demodex counts by daily lid massage with 5% TTOO.
authors.affiliation: Department of Ophthalmology, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China. gaoyingying@gmail.com
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Gao
authors.forename: Duan-lian
authors.initials: DL
authors.lastname: Xu
authors.forename: li-Juan
authors.initials: lJ
authors.lastname: Huang
authors.forename: Rong
authors.initials: R
authors.lastname: Wang
authors.forename: Scheffer C G
authors.initials: SC
authors.lastname: Tseng
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D002751:Chlortetracycline / Q000627:therapeutic use; D015822:Eye Infections, Parasitic / Q000150:complications* / Q000188:drug therapy; D005141:Eyelid Diseases / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008924:Mite Infestations / Q000150:complications* / Q000188:drug therapy; D011537:Pruritus / Q000188:drug therapy*; D020947:Tea Tree Oil / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D000981:Antiprotozoal Agents; D020947:Tea Tree Oil; D002751:Chlortetracycline