Case series characterizes clinical sequence for diagnosing Demodex

A recent case series published in Optometry & Vision Science describes an effective procedure for confirming the presence of Demodex folliculorum and Demodex brevis, conditions that are seen in all patients 70 and older, the authors said.

If a patient has a history of blepharitis, dry eye or ocular allergy and a slit lamp exam indicates cylindrical dandruff, the diagnosis of Demodex should be confirmed by evaluating epilated lashes with a light microscope, according to the study authors.

“Demodex folliculorum and Demodex brevis are ectoparasites with an astounding prevalence of 100% in patients aged 70 years and older,” the authors, led by Primary Care Optometry News Editorial Board member Milton M. Hom, OD, said in the article. “Every person in this age group is estimated to carry a colony of 1,000 to 2,000 mites. With such a high prevalence, little attention has been paid to the mite among eye care practitioners.”

In an associated article, one of the case series authors, Katherine M. Mastrota, OD, describes an alternate technique to isolate Demodex organisms by eyelash rotation within the follicle. The mites are made visible in follicles that may or may not display cylindrical cuffing characteristic of demodicidosis.

This method does not involve epilation, according to the abstract.