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Using Lotilaner Ophthalmic Solution, 0.25% to Treat <i>Demodex</i> Blepharitis in Patients Who Were Initially Misdiagnosed: A Case Series.

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Related Experiment Video

Updated: Aug 8, 2025

In Vivo Confocal Microscopy: A Standard Operating Procedure for The Detection of Demodex Mites at The Eyelid Margin
05:24

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Delphi Panel Consensus Regarding Current Clinical Practice Management Options for Demodex blepharitis.

Marjan Farid1, Brandon D Ayres2, Eric Donnenfeld3

  • 1Gavin Herbert Eye Institute, UC-Irvine, Irvine, CA, USA.

Clinical Ophthalmology (Auckland, N.Z.)
|March 6, 2023
PubMed
Summary
This summary is machine-generated.

Consensus was reached on Demodex blepharitis (DB) treatment, identifying collarettes as key indicators. Experts agreed that reducing collarettes is the primary goal for effective DB management and improved patient outcomes.

Keywords:
collarettescylindrical dandruffeyelid diseaseocular surface disease

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Area of Science:

  • Ophthalmology
  • Dermatology
  • Parasitology

Background:

  • Demodex blepharitis (DB) is a common eyelid condition.
  • Gaps in knowledge regarding effective DB treatment exist.
  • Ocular surface disease experts convened to address these gaps.

Purpose of the Study:

  • To achieve expert consensus on the optimal treatment strategies for Demodex blepharitis (DB).
  • To establish clear guidelines for diagnosing and managing DB based on expert opinion.

Main Methods:

  • A modified Delphi panel process was employed, involving 12 ocular surface disease experts.
  • Methods included a live roundtable discussion and three rounds of surveys.
  • Consensus was defined by specific Likert scale medians or agreement among 8 out of 12 panelists.

Main Results:

  • Experts agreed that effective treatment should reduce the need for mechanical interventions like lid scrubs.
  • Collarettes were identified as a surrogate for Demodex mites, with their reduction being the primary treatment goal.
  • Treatment should be initiated for patients with at least 10 collarettes, irrespective of other symptoms, and DB can be cured with potential for reinfestation.

Conclusions:

  • Consensus was achieved on key aspects of DB management, including the pathognomonic nature of collarettes.
  • Treatment efficacy can be monitored by observing the resolution of collarettes.
  • Increased awareness and standardized treatment monitoring will lead to improved patient care and clinical outcomes for DB.