Effectiveness of Oral Ivermectin Treatment in Cases Unresponsive to Classical Demodex Blepharitis Treatment

Demodex blepharitis is a common inflammatory eye condition caused by an overgrowth of Demodex mites on the eyelids, and lash follicles, Zeiss' glands and Meibomian glands that is often overlooked. The aim of this study is to investigate the effectiveness of ivermectin tablet oral treatment in cases unresponsive to classical Demodex blepharitis treatment.

A total of 35 patients (17 men and 18 women) with chronic symptomatic blepharitis were included in the study. Patients were admitted to Çekirge State Hospital and Bursa Dünyagöz Hospital Ophthalmology Clinics between December 12, 2017, and April 15, 2021, and were found to have Cylindrical dandruff resistant to classical Demodex blepharitis treatment. Following the classical Demodex treatment in these cases, oral ivermectin was started in two doses of 0.2 mg/kg, 30 days apart. The presence of Demodex in the eyelashes, ocular surface disease index (OSDI) score was evaluated before the classical Demodex blepharitis treatment and after the ivermectin treatment. A detailed biomicroscopic eye examination was performed in all cases.

Of the total 35 patients admitted to the hospital, 17 (48.6%) were men [mean ± standard deviation (SD): 48.41±15.62, min-max: 18-75] and 18 (51.4%) were women (mean ± SD: 51.17±14.98, min-max: 19-73). There was no statistically significant difference between men and women in terms of average age (p=0.598). OSDI scoring mean ± SD values before classical Demodex blepharitis treatment and after oral ivermectin treatment were 77.47±5.74 and 6.69±4.71, respectively.

In the treatment of Demodex related blepharitis, the use of oral ivermectin is an effective treatment option in cases that do not respond to classical treatment.