Demodex Blepharitis

Demodex blepharitis is a type of eyelid inflammation (blepharitis) caused by an overgrowth of microscopic mites called Demodex.

These mites naturally live on human skin, including the eyelid area, without causing any problems. However, when their numbers increase, they can trigger an inflammatory response that leads to blepharitis, a condition characterized by irritation, redness, and swelling of the eyelids. This condition is not contagious, it does not spread from one person to another.  

What are Demodex mites? 

Demodex mites are tiny, parasitic organisms that live in hair follicles and sebaceous (oil) glands of the skin. These mites also harbor bacteria, which greatly increases the number of bacteria on and around the eyes. There are two species that commonly affect humans: 

  • Demodex folliculorum: Found in hair follicles, especially on the face and eyelids. There are about 6-8 mites living in each infected follicle.  

  • Demodex brevis: Found within the Meibomian Glands. They may be a reason for Meibomian Gland Dysfunction.  

These mites feed on oils produced by the skin. This can cause an overpopulation of these mites and can disrupt the skin’s natural balance causing inflammation.  

Symptoms of Demodex Blepharitis 

Demodex blepharitis presents with symptoms like other forms of blepharitis, including: 

  • Red, swollen, and irritated eyelids. 

  • Itchy or burning sensation in the eyes. 

  • Crusty or flaky eyelash debris (often seen in the morning). 

  • Eyelash loss or misdirection. 

  • Dry eyes or a feeling of something gritty in the eye. 

  • Sensitivity to light. 

  • Occasionally, bacterial conjunctivitis (pink eye) may develop.  

Causes of Demodex Blepharitis 

Several factors may contribute to an overgrowth of Demodex mites on the eyelids, including: 

  • Poor eyelid hygiene: A buildup of oils, debris, or makeup residue can provide a favorable environment for mites to thrive. 

  • Age: Older adults tend to have more Demodex mites due to decreased skin cell turnover and changes in oil production. 

  • Chronic conditions: Conditions like rosacea and seborrheic dermatitis are associated with higher populations of Demodex. 

Diagnosis 

Our eyecare providers can diagnose Demodex blepharitis by examining the eyelids for signs of inflammation and mite infestation during the slit lamp examination.  

Treatment 

The primary goal of treatment is to reduce the Demodex population and control inflammation. Common treatments include: 

  • Prescription Eyedrops: Prescription eyedrops are available that will kill the mite and eliminate their presence. 

  • Low Level Light Therapy (Red Light Therapy): FDA approved/cleared medical grade light that is able to treat and manage demodex.  

  • In-Office Eyelid Cleansing: We offer Blephex treatments at our office. We are able to effectively clean your lids and lashes for you.   

  • Eyelid hygiene: We recommend regular cleaning of the eyelids with a Mybo Clean (manuka honey eyelid scrub). Ask us about it at your next eye exam.  

  • Oral medications: In some cases, oral antibiotics may be prescribed for severe cases. 

Prevention 

While it's difficult to completely eliminate Demodex mites, maintaining proper eyelid hygiene and managing underlying conditions (like rosacea) can help prevent flare-ups. Regular cleaning of the eyelids with Mybo Clean can help keep the mite population under control. 

No matter what brings you to Bogan Eyecare, you can trust that we’re dedicated to providing care that’s comprehensive, personalized, and focused on improving your quality of life. Ready to schedule your appointment?