Demodex and eye disease

Abstract

Demodex is the most common parasite living on humans and yet little is understood about its pathogenicity with respect to the ocular surface. An increasing interest in Demodex over the past 20years has increased our understanding of this mite and its pathogenetic role. This article begins with a review of the anatomy, life cycle, mode of transmission and advances in genetics that can distinguish between Demodex folliculorum and Demodex brevis, the only two Demodex species in humans. Additionally, a review of diagnostic procedures and existing and emerging ocular and systemic management options are presented. Despite the increasing interest in Demodex in the literature, there remains numerous obstacles for future studies, hence a section of this review is dedicated to the identification and proposal for future considerations. The lack of uniformity with respect to terminology, diagnostic technique and management approach for Demodex remain as obstacles for future study comparisons. This review summarised the current knowledge on Demodex and hopes to offer some recommendations for future directions in the study of Demodex in humans.

Ophthalmic manifestations of Demodex spp. infection – what should a dermatologist know?

“…Currently, there is no diagnostic standard for ocular demodecosis, which results in differences in incidence of demodicosis reported in various studies [25,34]. Potential diagnostic criteria for Demodex-induced blepharitis include medical history, slit lamp examination, and microscopic confirmation of infestation [13].…”

“…Obecnie nie ma standardu diagnostycznego demodekozy ocznej, co skutkuje różnicami w raportowanej częstości występowania nużeńców w poszczególnych badaniach [25,34]. Potencjalnymi kryteriami diagnostycznymi zapalenia powiek wywołanymi przez nużeńce jest wywiad, badanie w lampie szczelinowej i potwierdzenie infestacji w badaniu mikroskopowym [13].…”

“…Po kilku skrętach, zanieczyszczenia i opisthosomy roztoczy zaczynają wyłaniać się z mieszka. Ocena stanu miejscowego możliwa jest przy lampie szczelinowej przy wykorzystaniu powiększenia rzędu 25-40×, jak również poprzez przeniesienie na szkiełko podstawowe wy- Redness of eyelid margins/Zaczerwienienie powiek [5,10] Eyelid pruritus/Świąd powiek [34] Foreign body sensation under eyelids/Uczucie ciała obcego pod powiekami [3] A feeling of heaviness in eyelids/Uczucie ciężkości powiek [11] Burning sensation of eyelids/Pieczenie powiek [3] Eye irritation, conjunctival hyperaemia/Zadrażnienie oczu, przekrwienie spojówek [5,11] Increased sensitivity to light, smoke and dust/Zwiększona wrażliwość na światło, dym i kurz [3] Tearing/Łzawienie [22] Feeling of dry eyes/Uczucie suchości oczu [5] Mucinous discharge/Śluzowa wydzielina [11] Visual disturbance, glare/Zaburzenia widzenia, olśnienia [2] Contact lens intolerance/Nietolerancja soczewek kontaktowych [33] symptoms of ocular demodecosis found on physical examination/objawy demodekozy ocznej stwierdzane w badaniu przedmiotowym…”

Novel Molecule Lotilaner Could Potentially Offer Relief to Long-suffering Demodex Blepharitis Patients

“…1 There are several plausible mechanisms by which Demodex mites contribute to blepharitis, including direct mechanical damage, acting as a vector for bacteria, and inducing hypersensitivity and inflammation. [2][3][4] The infestation can also result in discomfort and psychosocial impacts (Figure 1). 5 In advanced stages, the disease may impact the cornea and lead to epithelial erosions, infiltrates, defects and keratitis.…”

Ocular therapeutics: from special interest to standard care

“…5 Bitton and Aumond remind us of a possible need to manage Demodex infestations of the ocular surface in symptomatic patients. 6 Ho et al 7 present an update on the contemporary management of commonly encountered contact lens complications and infections. Arshad et al 8 also provide a look back and forward on the impact of the herpetic eye disease study (HEDS) 20 years on.…”