Demodex blepharitis common, underdiagnosed in all patients
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BOSTON – More than half of patients in six eye centers had collarettes, a clinical sign of Demodex blepharitis, on their eyelashes, according to a study presented here at the American Academy of Optometry meeting.
Patients with blepharitis, glaucoma, dry eye disease, meibomian gland dysfunction, cataracts and rosacea; those who wear contact lenses; and those who use anti-inflammatory drugs or prostaglandins often have collarettes, Paul Karpecki, OD, and colleagues said.
They evaluated case records for 1,032 consecutive patients with any chief complaint in six geographically diverse clinical sites around the U.S. to determine the incidence of collarettes. Mean patient age was 60.4 years, and the majority were female.
Clinicians found collarettes in 58% of all patients, 69% of those with blepharitis, 65% of those with glaucoma, 60% of those with rosacea, 59% of those with dry eye, 57% of those with meibomian gland dysfunction, 56% of those with cataract and 51% of those wearing contact lenses, according to the presentation. They found collarettes in 73% of patients on oral steroids, 68% of those taking prostaglandins, 60% of those on prescription dry eye drops and 50% of those on topical steroids. Seventy-five percent of patients already using tea tree oil had collarettes, as did 57% of those using lid wipes.
“In this sample, the condition was as common as dry eye, and collarettes were just as prevalent (or more so) among those already using lid hygiene measures,” according to the study abstract.
Considering these numbers, up to 25 million people may have Demodex blepharitis, suggesting a need for effective medications, researchers said.
Karpecki noted in the presentation that collarettes can be visualized easily at the slit lamp by simply asking patients to look down.
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Karpecki P, et al. Prevalence of collarettes, the pathognomonic sign of Demodex blepharitis, in patients presenting for routine eye care visits. Presented at: American Academy of Optometry annual meeting; Nov. 2-6, 2021; Boston.
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