Abstract
Purpose :
Anterior and posterior blepharitis and meibomian gland dysfunction (MGD) are very common diseases in the ophthalmologic practice. These usuallly follow a chronic clinical course with intermittent exacerbations. Demodex folliculorum infestation is often overlooked and it may be the causative parasite particularly in chronic blepharitis unresponsive to blepharitis treatment.Our aim is o present the course and treatment outcome of patients with chronic blepharitis , MGD and keratitis who had D. folliculorum infestation.
Methods :
This study comprised 82 patients with complaints of burning, stinging, dryness and crusting of eyelids in two months time. Sixteen patients whose chronic blepharitis unresponsive to treatment that consisted of topical antibiotic, steroid and artificial tear at least for one year were included in the study. All the patients underwent complete ophthalmologic examination, tear meniscus height, tear break up time and corneal fluorescein staining evaluation. Lash samples of the 16 patients were examined under light microscope ( x10, x40) for D. folliculorum infestation
Results :
The mean age of the patients was 48 years. Of lash samples of 16 patients, 12 (75%) were positive for D. folliculorum. If at least one mite on one lash was found, the result was expressed as positive and if no mite was identified the result was expressed as negative. All mite positive patients underwent treatment with topical tea tree oil and they were all clinically improved at one month follow up. Four patients undertreatment were reevaluated for Demodeks infestation. Their lash samples were examined and all had decreased count of demodex but only one was found negative for Demodex. Tear meniscus height, tear break up time and corneal fluorescein staining were all statistically improved with tea tree oil treatment besides relief of the symptoms.
Conclusions :
In chronic blepharitis with corneal complications, Demodex infestation should be kept in mind for differential diagnosis. The clinical improvement may be noted even if the mites are not totally eradicated.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.