Demodex Blepharitis

Demodex Blepharitis

Demodex is an 8-legged ectoparasite, meaning it lives on the surface of a host. It can live in hair follicles and sebaceous (oil) glands.

Blepharitis is a condition of eyelid inflammation that causes inflammation, as well as disruption in tear production.

Pictured: One of the primary observations made by an eye-care professional is collarettes around the eyelashes, prompting further investigation of demodex.

Demodex infestation of the eyelids causes blepharitis. They have a life span of 2-3 weeks and lay about 15-20 eggs each in the eyelash hair follicle near the sebaceous glands. They consume epithelial cell cytoplasm by piercing through the cell membrane.


Once demodex are discovered via a slit lamp examination, a full debridement of lashes and eyebrows is done using a cotton tip applicator soaked in 100% tea tree oil solution. This irritates the mites and stimulates them to leave the eyelash follicle.

This process is repeated after 10 minutes.

The eyelids are treated with antibiotics and steroids. These prevent mites from moving and possibly suffocates them.

The steroid treatment specifically helps calm the inflammation that results from the irritation of the procedure. It also suppresses possible inflammatory cascade associated with the decaying mites.

Important Instructions:

Þ Return for a two week repeat treatment

Þ Use eyelid scrubs every night to clean the eyelashes

Þ Remove all sheets and pillowcases and wash, drying on a high setting.

Þ Discard pillows

Þ Discard makeup and do not wear makeup for one week

Þ Use tea tree soap to wash your face and a tea tree shampoo for your hair

Þ Make an appointment for your spouse or partner to be evaluated

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Mid Atlantic Cornea Consultants
Sudeep Pramanik MD MBA FACS

Towson, Maryland Ophthalmologist, Dr. Sudeep Pramanik is dedicated to excellence in ophthalmology such as referrals for complex surgery, management of cornea and anterior eye disease, and laser refractive surgery.

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