Psychosocial Impact of Demodex Blepharitis

Abstract

Purpose To evaluate the impact of Demodex blepharitis on patients’ daily activities and quality of life. Patients and Methods In this multicenter, observational, prospective, IRB-approved study, 311 Demodex blepharitis patients aged ≥18 years were included. Demodex blepharitis was diagnosed based on the presence of ≥1.0 mite per lash (upper and lower eyelids combined), >10 collarettes on the upper lashes, and at least mild lid margin erythema of the upper eyelid in at least one eye. All patients were asked to complete a questionnaire about their symptoms, daily activities, quality of life, and management approaches, and descriptive statistics were used to analyze the responses. Results More than half the patients had been experiencing symptoms of blepharitis for ≥4 years. The three most frequent and bothersome symptoms experienced by patients were dry eyes, itchiness, and irritation. Nearly half the patients (47%) responded that they were conscious of their eyes all day, and 23% said that they were constantly worrying about their eyes. Other activities that were negatively affected included difficulty driving at night (47%), additional time needed for daily hygiene routine (30%), and difficulty in wearing eye make-up (in 34% of females). While all subjects had objective signs of Demodex blepharitis confirmed by an eye care provider, 58% said they had never previously been diagnosed with blepharitis. The most commonly used management approaches for Demodex blepharitis were artificial tears (47%), warm compresses (32%), and lid wipes (14%). Conclusion Demodex blepharitis has a significant negative impact on daily activities and the mental and physical well-being of afflicted patients.

Demodex Blepharitis: A Comprehensive Review of the Disease, Current Management, and Emerging Therapies

“…Given that the purpose of the eyelashes is to protect the ocular surface and direct airflow away from it, mite-induced follicular damage that results in lash misdirection or loss may make patients more symptomatic or negatively impact ocular surface health. 14 Eyelid margin erythema and telangiectasia are also commonly seen in Demodex blepharitis 22,49,53 and may contribute to patients' perception of a negative cosmetic appearance. 53…”

“…14 Eyelid margin erythema and telangiectasia are also commonly seen in Demodex blepharitis 22,49,53 and may contribute to patients' perception of a negative cosmetic appearance. 53…”

“…Ocular itching is the symptom most commonly associated with Demodex blepharitis, 11,35,[50][51][52][53] and evidence suggests that patients consider ocular itching to be one of the most bothersome symptoms associated with the disease. 53 Demodex-related itching may be more likely to occur at night or early morning after periods of mite activity, 5,35 distinguishing it from daytime, allergy-related itching.…”

“…Ocular itching is the symptom most commonly associated with Demodex blepharitis, 11,35,[50][51][52][53] and evidence suggests that patients consider ocular itching to be one of the most bothersome symptoms associated with the disease. 53 Demodex-related itching may be more likely to occur at night or early morning after periods of mite activity, 5,35 distinguishing it from daytime, allergy-related itching. Dry eye or blepharitis patients with Demodex are significantly more likely to report itching than those without Demodex, 3,11 and the frequency of itching complaints increases with higher Demodex density.…”

“…Symptoms reported by patients with confirmed Demodex blepharitis ( N¼301). 53 Intense pulsed light (IPL) [72][73][74][75] In-office treatment Reduces mean Demodex mite density Contraindicated in Fitzpatrick V and VI skin tones, cost Improves ocular surface parameters Microblepharoexfoliation (MBE) 2,29,76 In-office treatment to remove lid and lash debris…”