HEMANTH, real patient with DB

Untreated Demodex blepharitis (DB) can have serious consequences

HEMANTH, real patient with DB

DB affects patients physically, functionally, and psychosocially

of patients with DB say
it negatively affects their lives3,*

*A multicenter, observational, prospective study that included 311 patients with DB aged ≥18 years who were asked to complete a questionnaire about their symptoms and daily activities.
*A multicenter, observational, prospective study that included 311 patients with DB aged ≥18 years who were asked to complete a questionnaire about their symptoms and daily activities.

One collarette may be just the beginning

DB can trigger new problems for patients — or may make existing problems worse1,4

  • ~57% of patients with MGD have DB†
  • Through their physical presence in the glands or through inflammation, mites cause:
    • Obstruction of gland orifices
    • Decrease in meibum quality
    • Reduced gland expressibility
    • Gland atrophy or loss
†STUDY DESIGN: A retrospective chart review for DB by 7 investigators at 6 eye care clinics of the case records of patients (N=1032) who underwent a slit lamp examination, regardless of chief complaint.

  • DB is common in surgical candidates
    • In a large US clinical study, more than half of the patients presenting for cataract surgery had DB
  • DB is associated with increased MMP-9 and reduced TBUT, which may disrupt ocular surface homeostasis and patient satisfaction, particularly for premium IOL implant patients
  • Preexisting lid margin disease (blepharitis) is a recognized risk factor for postoperative endophthalmitis after intraocular surgery
  • DB prevalence has been reported to increase after cataract surgery, especially following topical steroid use
IOL=intraocular lens; MMP-9=matrix metalloproteinase-9;
TBUT=tear break-up time.

  • Symptoms from DB and MGD can impact tear film integrity
  • A large study found that Demodex-infested eyes had significantly shorter noninvasive tear break-up time, indicating a potentially reduced tear film stability
  • In a study to investigate the relationship between Demodex infestation and ocular surface manifestations in MGD (N=86), patients with MGD and Demodex infestation showed higher tear film MMP-9, greater symptom burden (OSDI), and more corneal straining than those without Demodex infestation
  • Other studies have shown that patients with Demodex infestation have lower Schirmer test scores and higher OSDI scores than patients without DB
MMP-9=matrix metalloproteinase-9; OSDI=Ocular Surface Disease Index.

  • Wearing contact lenses may increase the susceptibility to Demodex infestation by altering the ocular surface microbiome
  • Studies have documented a high degree of overlap between Demodex infestation and soft-contact lens (SCL) intolerance
    • Up to 51% of patients wearing SCLs have DB
    • ~93% of SCL-intolerant patients had Demodex infestation‡
  • Inflammation, excessive keratinization, and hyperplasia of the eyelid epithelium, which can be due to DB, may cause discomfort to the point of lens abandonment
‡In a study of people who used SCLs (N=62) for a period exceeding 6 months, individuals who reported discomfort while wearing their contact lenses (n=28) were compared with others who reported no discomfort (n=34). The aim of the study was to identify any relationship between the incidence of Demodex mites in the eyelash hair follicles of patients using SCLs and the abandonment of these lenses by their users.
MGD=meibomian gland disease.

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