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

Demodex mite infestation can cause inflammation of the eyelid margin, and Demodex blepharitis could give rise to a series of ocular conditions in clinical cases. Numerous physicians diagnose ocular infestation of Demodex mites through eyelash epilation and the observation of eyelashes under light microscopy in vitro. However, the presence of residual mites following eyelash removal and the pain associated with the procedure are limitations of standard clinical care. In vivo confocal microscopy (IVCM) is a non-invasive imaging technique that allows clinicians to observe Demodex mites at the eyelid margin in detail without epilation. This technique enables painless analysis that can be completed in <30 min. Despite growing attention being paid to this examination, it may be inaccessible to many ophthalmologists without extensive experience. This paper presents a standard operating procedure for the visualization of Demodex mites at the eyelid margin with IVCM to promote increased adoption of this method in clinical work.