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Updated: Feb 14, 2026

In Vivo Confocal Microscopy: A Standard Operating Procedure for the Detection of Demodex Mites at the Eyelid Margin

In Vivo Confocal Microscopy: A Standard Operating Procedure for the Detection of Demodex Mites at the Eyelid Margin

Published on: July 3, 2025

Bullous eyelid.

Zahra N Jaffer^1,2, Cherie Nicholson³

¹Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.

BMJ Case Reports

|February 24, 2018

Summary

This summary is machine-generated.

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Periocular necrotising fasciitis is a rare, sight-threatening condition. Early clinical recognition and prompt treatment, including antibiotics and debridement, are crucial for a positive outcome.

Area of Science:

Ophthalmology
Infectious Diseases
Surgical Infections

Background:

Periocular necrotising fasciitis is a rare, severe soft tissue infection.
Timely diagnosis is challenging, relying heavily on clinical presentation.
This condition poses a significant risk to vision and patient survival.

Observation:

A 51-year-old female presented with acute bilateral eye swelling, erythema, and pain.
The patient rapidly developed sepsis, necessitating fluid resuscitation and transfer to a higher care facility.
Initial management included broad-spectrum intravenous antibiotics.

Findings:

Surgical debridement was performed, followed by continued intravenous antibiotics.
The patient's condition improved, allowing for a step-down to oral antibiotics.

Keywords:

dermatology emergency medicine general practice / family medicine infectious diseases

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Last Updated: Feb 14, 2026

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Prompt diagnosis and aggressive treatment led to a favorable outcome.

Implications:

Highlights the importance of high clinical suspicion for periocular necrotising fasciitis.
Emphasizes the critical role of multidisciplinary care in managing severe infections.
Underscores the need for rapid intervention to prevent vision loss and systemic complications.