Demodex collarettes associated with itching, fluctuating vision
Key takeaways:
- Collarettes are a pathognomonic sign of Demodex blepharitis.
- The Janus study found a correlation between collarettes and itching, fluctuating vision, irritation and redness.
ATHENS, Greece — Collarettes are a pathognomonic sign of Demodex blepharitis and are significantly correlated with symptoms such as itching, fluctuating vision, irritation and redness, according to a study.
“Demodex blepharitis is a pervasive, damaging eyelid disease that is caused by overgrowth of the Demodex mites,” Ruth Lapid-Gortzak, MD, PhD, said at the ESCRS winter meeting. “They are the most common ectoparasite in humans.”
In the Titan study performed in the U.S., 58% of the more than 1,000 subjects included were found to carry Demodex; 99% of those subjects had symptoms.
Patients with collarettes have symptoms, Lapid-Gortzak said.
“Collarettes are translucent, solidified excretions from regurgitated, undigested mite waste,” she said.
Demodex blepharitis is easily diagnosed by asking the patient to look down. This will reveal the presence of cylindric secretions on the eyelashes at the lid margin.
The Janus study that Lapid-Gortzak presented explored the correlation between the number of collarettes and the symptoms of Demodex blepharitis. One hundred patients with one or more collarettes were included and compared with 47 controls. Clinically meaningful differences in visual analog scale score were found in the Demodex group compared with the control group for itching, fluctuating vision, irritation and redness. The most prevalent localization of itching related to Demodex blepharitis was at the lid margin.
During the discussion, Lapid-Gortzak told the audience that no treatment is currently available in Europe for Demodex blepharitis.
“I can tell my patients to use grandmom’s compresses and tea tree oil, but I don’t think it helps,” she said. “We know that in the U.S. there is a drug for this bug, and we have good reason to use it.”
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Lapid-Gortzak R. Evaluation of the Demodex blepharitis specific symptoms: The Janus study. Presented at: ESCRS winter meeting; Feb. 28-March 2, 2025; Athens, Greece.
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