Diagnosing Demodex blepharitis (DB) starts
with the lids

Marissa, real patient with DB
Marissa, real patient with DB

DB will not resolve on its own.1-3

Act at the first sign.

Collarettes: the pathognomonic sign of DB1,2

Demodex mites may be too small to see, but collarettes are not. All you need is a slit lamp to confidently diagnose DB.

Patient looking straight ahead with lid lift; no collarettes are visible

Same patient looking down; collarettes are visible

Images by Elizabeth Yeu, MD
Slit lamp evaluation, 10x magnification

Patient looking straight ahead with lid lift; no collarettes are visible

Same patient looking down; collarettes are visible

Images by Paul Karpecki, OD
Slit lamp evaluation, 10x magnification

Patient looking straight ahead with lid lift; no collarettes are visible

Same patient looking down; collarettes are visible

Images by Justin Schweitzer, OD
Slit lamp evaluation, 10x magnification

LID LIBRARY

Collarettes are the key diagnostic sign of DB.1,2

Explore real-world images from healthcare professionals nationwide.

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JACLYN GARLICH, OD
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Vin Dang, OD
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Elizabeth Yeu, MD
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Cory J Lappin, OD
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Alice Epitropoulos, MD
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Cecelia Koetting, OD
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Justin Schweitzer, OD
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Cory J Lappin, OD
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Marc Bloomenstein, OD
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Cory J Lappin, OD
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Cory J Lappin, OD
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Ben Gadde, OD
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Elizabeth Yeu, MD
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Paul Karpecki, OD
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Erick Henderson, OD
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Erick Henderson, OD
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Paul Karpecki, OD
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Paul Karpecki, OD
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Paul Karpecki, OD
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Paul Karpecki, OD
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Paul Karpecki, OD
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Alice Epitropoulos, MD
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Paul Karpecki, OD
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Elizabeth Yeu, MD
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Elizabeth Yeu, MD
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Elizabeth Yeu, MD
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Elizabeth Yeu, MD
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Elizabeth Yeu, MD
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Vin Dang, OD
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Paul Karpecki, OD
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Neda Shamie, MD
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Caroline Watson, MD
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Alice Epitropoulos, MD
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Alice Epitropoulos, MD
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Alice Epitropoulos, MD
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Erick Henderson, OD
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Alice Epitropoulos, MD
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Alice Epitropoulos, MD
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JACLYN GARLICH, OD
IMAGE CREDIT
Vin Dang, OD
IMAGE CREDIT
Elizabeth Yeu, MD
IMAGE CREDIT
Cory J Lappin, OD
IMAGE CREDIT
Alice Epitropoulos, MD
IMAGE CREDIT
Cecelia Koetting, OD
IMAGE CREDIT
Justin Schweitzer, OD
IMAGE CREDIT
Cory J Lappin, OD
IMAGE CREDIT
Marc Bloomenstein, OD
IMAGE CREDIT
Cory J Lappin, OD
IMAGE CREDIT
Cory J Lappin, OD
IMAGE CREDIT
Ben Gadde, OD
IMAGE CREDIT
Elizabeth Yeu, MD
IMAGE CREDIT
Paul Karpecki, OD
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Erick Henderson, OD
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Erick Henderson, OD
IMAGE CREDIT
Paul Karpecki, OD
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Paul Karpecki, OD
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Paul Karpecki, OD
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Paul Karpecki, OD
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Paul Karpecki, OD
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Alice Epitropoulos, MD
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Paul Karpecki, OD
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Elizabeth Yeu, MD
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Elizabeth Yeu, MD
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Elizabeth Yeu, MD
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Elizabeth Yeu, MD
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Elizabeth Yeu, MD
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Vin Dang, OD
IMAGE CREDIT
Paul Karpecki, OD
IMAGE CREDIT
Neda Shamie, MD
IMAGE CREDIT
Caroline Watson, MD
IMAGE CREDIT
Alice Epitropoulos, MD
IMAGE CREDIT
Alice Epitropoulos, MD
IMAGE CREDIT
Alice Epitropoulos, MD
IMAGE CREDIT
Erick Henderson, OD
IMAGE CREDIT
Alice Epitropoulos, MD
IMAGE CREDIT
Alice Epitropoulos, MD

Diagnosing DB is easy when you know what to look for2

Have your patients look down
Check for collarettes on the upper eyelid region under a slit lamp
JEANETTE, real patient with DB
TIP: Collarettes can be missed when patients look straight ahead. They are more clearly visible when patients look down at the slit lamp — especially under magnification.

Once DB is confirmed, go after the root cause.

There’s more to see when you look at the lids

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1. Fromstein SR, Harthan JS, Patel J, Opitz DL. Demodex blepharitis: clinical perspectives. Clin Optom (Auckl). 2018;10:57-63. 2. Trattler W, Karpecki P, Rapoport Y, et al. The prevalence of Demodex blepharitis in US eye care clinic patients as determined by collarettes: a pathognomonic sign. Clin Ophthalmol. 2022;16:1153-1164. 3. Yeu E, Garg S, Ayres BD, et al. Current state and future perspectives in the diagnosis of eyelid margin disease: clinical review. J Cataract Refract Surg. 2024;50(8):868-875.