Demodex blepharitis treatment with a selenium sulfide-containing ointment: a case report

Demodex blepharitis is a chronic, progressive condition characterized by inflammation, ocular irritation, and erythema due to an overgrowth of mites in hair follicles and oil glands of the eyelids. AZR-MD-001(AZR) is a selenium sulfide-containing ophthalmic ointment that is a potential treatment option for Demodex blepharitis. We wished to complete a case study to identify the potential of this agent to treat Demodex blepharitis. A patient with chronic Demodex blepharitis applied AZR 0.5% to the right lower eyelid every other day at bedtime for 6 weeks, discontinued treatment for 6 weeks, then treated the left lower eyelid with vehicle only for 6 weeks, followed by use of AZR 0.5% for both lower eyelids twice a week for 6 weeks. Eyelashes were removed and pooled for evidence of mites and collarettes before and after the first treatment, and eyes were inspected for signs of blepharitis before and after each treatment period. After treatment with AZR 0.5%, resolution of blepharitis occurred in the treated eye, with no evidence of Demodex mites. The untreated eye showed no difference from baseline. After discontinuing for 6 weeks, the signs of blepharitis returned, similar to baseline. After 6 weeks of vehicle application to the left eye, no changes in signs were observed. After treatment with AZR 0.5% for 6 weeks to both eyes, complete resolution of blepharitis occurred in both eyes. No adverse events were reported. Treatment with AZR 0.5% was efficacious in eradicating Demodex blepharitis, which was not evidenced when using vehicle or a lack of treatment. This demonstrated a potential new use for AZR to treat Demodex blepharitis. Further studies are required to establish the safety and efficacy of this product.