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Pilocarpine gel for the treatment of demodicosis--a case series
G W Fulk1, B Murphy, M D Robins
1College of Optometry, Northeastern State University, Tahlequah, Oklahoma, USA.
Background:
Excessive numbers of the mite, Demodax folliculorum, in the eyelash follicies cause itching and is referred to as demodicosis. We evaluated 4% pilocarpine gel as a treatment for this condition.
Methods:
An advertisement was placed in a retirement home newsletter, requesting persons with ocular discomfort. Respondents were examined for Demodex and persons with abundant mites were invited to participate. One eye was treated with pilocarpine gel; the other eye was untreated. The relative abundance of mites was evaluated at baseline, after 1 and 2 weeks of treatment. Subjects kept a daily log of symptoms.
Results:
Eleven of 22 persons with ocular itching had abundant Demodax. Mites were reduced significantly by the treatment (p = 0.017). The amount of mite reduction was closely correlated with the extent to which itching was alleviated (r = 0.811, p = 0.008).
Conclusion:
Abundant Demodex is an important cause of ocular itching in older persons. Mites can be reduced with pilocarpine gel and itching alleviated.