Demodex is the most common parasite living on humans and yet little is understood about its pathogenicity with respect to the ocular surface. An increasing interest in Demodex over the past 20years has increased our understanding of this mite and its pathogenetic role. This article begins with a review of the anatomy, life cycle, mode of transmission and advances in genetics that can distinguish between Demodex folliculorum and Demodex brevis, the only two Demodex species in humans. Additionally, a review of diagnostic procedures and existing and emerging ocular and systemic management options are presented. Despite the increasing interest in Demodex in the literature, there remains numerous obstacles for future studies, hence a section of this review is dedicated to the identification and proposal for future considerations. The lack of uniformity with respect to terminology, diagnostic technique and management approach for Demodex remain as obstacles for future study comparisons. This review summarised the current knowledge on Demodex and hopes to offer some recommendations for future directions in the study of Demodex in humans.
The primary role of eyelashes is to protect and maintain the health of the lid margin. However, the mechanisms to fulfill this role are not fully understood. Unraveling these mechanisms will stand to greatly improve the efficiency of eye care professionals’ interventions in anomalies of the eyelashes. The aim of this article is to provide a review on eyelashes including highlights and new avenues for research; the biology of both the lash and its follicle; the pathophysiology and management of lash anomalies by eye care professionals; and the effect of iatrogenic factors on lashes. Using the database of Ovid MEDLINE, we reviewed studies specifically directed on human/mammalian eyelashes and key articles on current trends in scalp hair methodologies that can be applicable to lash research. The eyelash morphology, pigmentation and growth rate have been documented using techniques ranging from lash imaging to follicle immunohistochemistry. Furthermore, studies have demonstrated that the lash follicle is sensitive to many factors of the external environment, a variety of systemic/topical medications and cosmetics. Recently, aerodynamic studies using a mammalian eye model confirmed that an optimal lash length was needed so that eyelashes serve a protective role in reducing the number of particles that can reach the eye. Despite recent advances in lash research, studies are still scarce, due to the limited availability of the human lid for sampling. This review brings awareness that further research is needed with respect to eyelashes and will hopefully reduce the gap with scalp hair research.
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