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[Blepharitis. Demodex folliculorum, associated pathogen spectrum and specific therapy]
M Demmler1, H M de Kaspar, C Möhring
1Augenklinik, Universität München.
Summary
Demodex mites are frequently found in chronic blepharitis patients and may cause therapy resistance. Mercury ointment and lindan show efficiency in treating Demodex-associated blepharitis, despite application challenges.
Area of Science:
- Ophthalmology
- Microbiology
- Dermatology
Background:
- Demodex folliculorum is frequently observed in blepharitis patients.
- This mite is implicated in therapy-resistant blepharitis cases.
Purpose of the Study:
- To investigate the microbial spectrum in patients with blepharitis and Demodex infestation.
- To evaluate the efficacy of specific therapeutic interventions for Demodex-positive blepharitis.
Main Methods:
- Examination of 3152 cilia from 139 blepharitis patients and 108 controls for Demodex.
- Bacterial investigation of conjunctival smears from symptomatic patients.
- Therapeutic trial involving mercury ointment, lindan, corticosteroids, or antibiotics in Demodex-positive blepharitis patients.
Main Results:
- Demodex was detected in 52% of chronic blepharitis cases, significantly higher than in acute blepharitis (20%) and controls (29%).
- Gram-positive cocci and gram-negative rods were more prevalent in Demodex-positive patients.
- Mercury ointment (2%) and lindan demonstrated the highest efficacy in eliminating Demodex parasites.
Conclusions:
- Demodex infestation is associated with increased bacterial presence in blepharitis.
- Demodex mites appear to be a significant factor in chronic blepharitis.
- Mercury ointment (2%) and lindan are effective treatments for Demodex-positive blepharitis, though toxicity and application are concerns.