June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Clinical Manifestations of Demodex Blepharitis
Author Affiliations & Notes
  • Scott Schachter
    Ocular Surface Academy, Pismo Beach, California, United States
  • Elizabeth Yeu
    Virginia Eye Consultants, Norfolk, Virginia, United States
  • Mark J. Holdbrook
    Tarsus Pharmaceuticals, Inc., Irvine, California, United States
  • Stephanie N. Baba
    Tarsus Pharmaceuticals, Inc., Irvine, California, United States
  • Paul J Gomes
    Ora Inc, Ora Inc, Andover, MA, US, corporate/medsupport, Andover, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Scott Schachter, Alcon (C), Allergan (C), Azura Ophthalmics (C), Bausch Health (C), Box Medical Solutions (C), Dompe Pharma (C), EpiTech Mag (C), Kala Pharmaceuticals (C), Lumenis Inc (C), Maculogix (C), Novartis (C), Oasis Medical (C), Osmotica Pharma (C), Regener-Eyes (C), Science Based Health (C), Sight Science Inc (C), Sun Pharma (C), Tarsus Pharmaceuticals, Inc (C), Triad Life Sciences (C); Elizabeth Yeu, Tarsus Pharmaceuticals, Inc (C); Mark Holdbrook, Tarsus Pharmaceuticals, Inc (E); Stephanie Baba, Tarsus Pharmaceuticals, Inc (E); Paul Gomes, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1268. doi:
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      Scott Schachter, Elizabeth Yeu, Mark J. Holdbrook, Stephanie N. Baba, Paul J Gomes; Clinical Manifestations of Demodex Blepharitis. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1268.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Blepharitis affects approximately 20 million Americans, of whom about 45% have an associated Demodex mite infestation. We analyzed a large data set of patients with confirmed Demodex blepharitis to characterize the population affected by this condition and to better understand their symptoms and motivations for seeking care.

Methods : Adult patients (age ≥18) with Demodex blepharitis were examined clinically and asked questions about their ocular symptoms, diagnoses, and history. These 311 patients had objective signs of Demodex blepharitis, including the presence of Demodex mites, presence of collarettes (cylindrical dandruff) on the lashes, and lid margin erythema. Questionnaire responses from these 311 patients with confirmed Demodex blepharitis were analyzed.

Results : Among these Demodex blepharitis patients, 38% were male; 62% female. The mean age was 67 (range: 23 to 92). Over half of them (51%) had been experiencing signs and symptoms of blepharitis for at least 4 years, but most (58%) had never been diagnosed with blepharitis. There was a high degree of overlap with other ocular surface conditions, including those having been previously diagnosed with dry eye (81%), rosacea (3%), or both (16%). The most bothersome symptoms for patients were itchy eyes, dry eyes, foreign body sensation, and eyes tearing (Fig 1). The majority experienced symptoms of dryness, itching, and ocular irritation frequently or all of the time in the past month. 28% had first seen an optometrist about their symptoms, while 61% had seen an ophthalmologist and 11% had gone to a primary care physician. Although most had seen a doctor only once, 33% had made at least 2, and sometimes more than 6, visits to a doctor for this condition. 81% of patients seek some type of treatment for the condition. Of those who discontinued treatment, 43% discontinued due to ineffectiveness, tolerability issues, or other reasons. Women were more likely than men to have tried medication to treat their symptoms (90% vs. 66%).

Conclusions : The symptom burden of blepharitis is considerable and leads patients to seek treatment and medical care, mostly unsuccessfully. Proven safe and effective treatments for Demodex blepharitis are needed.

This is a 2021 ARVO Annual Meeting abstract.


Fig 1: Most Bothersome Symptoms of Demodex Blepharitis

Fig 1: Most Bothersome Symptoms of Demodex Blepharitis


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