Abstract
Purpose :
Demodex blepharitis (DB) is a highly prevalent, chronic eyelid disease that can have a significant burden on the patients. Until recent FDA approval of lotilaner ophthalmic solution 0.25%, various management options and medications, were used off-label for symptom management in DB. The aim of this study is to evaluate the response of ocular symptoms in DB patients who have used non-FDA approved or off-label medications and management options.
Methods :
A web-based survey was conducted among US patients (21 – 85 years of age) with a confirmed DB diagnosis by a healthcare provider from June to August 2022. Patients were asked about their ocular symptoms and the quality of life, mental and physical burden, of DB.
Results :
A total of 113 patients with DB responded to the survey. 21% of respondents reported using a prescription anti-inflammatory dry eye topical medication, 16% hypochlorous acid, 8% ivermectin, 27% oral antibiotics, 18% topical antibiotics, 55% tea tree oil, and 68% warm eye compress. Of the DB patients on topical dry eye medication, only 46% had a diagnosis of dry eye disease. Compared to those who were not on dry eye medications (79%), DB patients on dry eye medications tended to experience higher rates of ocular redness (38% vs. 28%), itchy eyes (33% vs. 27%), swollen eyelids (33% vs. 18%), ocular burning or stinging (25% vs. 18%), difficulty wearing contact lenses (25% vs. 13%), and crusted eyelashes (25% vs. 12%). Similar trends were observed for all symptoms (especially for ocular redness) when comparing those on and not on hypochlorous acid (41% vs. 28% for ocular redness), ivermectin (44% vs. 29%), oral antibiotics (45% vs. 24%), topical antibiotics (37% vs. 28%), tea tree oil (31% vs. 29%) and warm eye compress (36% vs. 18%).
Conclusions :
The results highlight the unclear benefit of prescription immunomodulatory dry eye topical medications used off-label and other management options in alleviating ocular symptoms in patients with DB. Off-label use of therapies, including prescription anti-inflammatory topical medications, may worsen the symptomatology of DB patients.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.