Abstract
Purpose: :
To investigate the clinical effect of 7% tea tree oil lid scrub on demodex blepharitis.
Methods: :
The medical records of seventy-two patients who were diagnosed with demodex blepharitis at Seoul National University Hospital from August, 2010 to July, 2011 were retrospectively reviewed. 4 lashes with cylindrical dandruffs at each upper lid were taken off, and the number of demodex/4 lashes was counted under a microscope. The patients scrubbed lids twice a day with 7% tea tree oil mixed in blephasol® (Laboratoires Thea, Clermont-Ferrand, France) for 2 to 4 months. Ocular surface disease indices (OSDIs) were questioned and ophthalmic examinations including tear film break up time (BUT), and Schirmer strip test were evaluated at the time of diagnosis, 2 and 4 months after the treatment.
Results: :
After 2 months of the treatment, demodex count significantly decreased from 3.83 to 2.10 (p=0.002, Wilcoxon signed rank test) and OSDI score markedly decreased from 27.91 to 15.35 (p=0.03). BUT was significantly increased from 3.90 seconds to 6.00 seconds (p=0.02), while the Schirmer test showed no change. When we compared the indices in 2 months-treated patients with those in 4 months-treated patients, the demodex count and the OSDI score tended to decrease but did not show any statistical significance between those two. The treatment effect was much more dramatic in high-burdened patients who had demodex more than 4, by attenuating both demodex count and OSDI score, while there were no significant change in demodex count and OSDI score in low-burdened patients who had demodex less than 2. Corneal erosion developed in 1.3% of the patients, which was healed after cessation of the treatment.
Conclusions: :
2 months of lid scrubbing using 7% tea tree oil seemed to be effective on the demodex associated blepharitis in the high-burdened patients who had demodex more than 4 per 4 lashes.
Keywords: eyelid • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • inflammation