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Speaker: Demodex treatment often empirical
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ATLANTA – A speaker here at SECO said that while the incidence of Demodex blepharitis seems to be increasing, a definitive diagnosis is difficult, and only one type of treatment is available.
“I’ve been practicing for 27 years, and I don’t think I’ve ever made a diagnosis of Demodex,” Mark Dunbar, OD, of the Bascom Palmer Eye Institute, said here at a continuing education presentation. “I recognize that it’s out there; patients older than 75 or 80 years all seem to have Demodex. I’m more prone to pulling a lash and looking at it due to the attention Demodex has been getting recently.”
“A lot of elderly patients end up becoming colonized with this,” co-presenter Richard Awdeh, MD, also from Bascom Palmer, agreed. “In cases of chronic blepharitis, where they’re not improving, this is one diagnosis to consider. And I consider tea tree oil.”
Mark Dunbar
Dunbar recommended purchasing a $200 microscope so a lash can be pulled and put on a slide in order to make a definitive diagnosis.
He noted that the only available treatment, tea tree oil, must be diluted due to its potential for toxicity.
“We’re using a lot of Cliradex (Bio-Tissue),” Dunbar said, “an eyelid/facial cleaner in a towelette with a special variety of tea tree oil: 4-terpineol.
“The downside is that it’s not available at the local drug store, but you can carry it, or patients can order it online,” he added.
Dunbar said he has had good results with this treatment.
“I’ve empirically treated, and they seem to have a positive response, although I had no confirmation of the Demodex,” he said. “However, given their age and profile, I suspected it.” – by Nancy Hemphill, ELS
Disclosures: Awdeh and Dunbar have no relevant financial interests.