The Dry Eye Zone

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Abstract: Demodex in pediatric bleph

Ocular demodicosis as a potential cause of pediatric blepharoconjunctivitis.

PURPOSE: To report Demodex infestation in pediatric blepharoconjunctivitis.

METHODS: A retrospective review of 12 patients, with ages from 2.5-11 years, with chronic blepharoconjunctivitis who failed to respond to conventional treatments. Demodex was detected by lash sampling and microscopic examination. Patients were treated with 50% tea tree oil (TTO) eyelid scrubs or 5% TTO ointment eyelid massages for 4-6 weeks.

RESULTS: Demodex mites were found in all, but 1 case had cylindrical dandruff in the lashes. After 1 week of TTO treatment, all patients showed dramatic resolution of ocular irritation and inflammation while Demodex counts dropped. All corneal signs resolved within 2 weeks except for a residual anterior stromal scar in 1 eye. During a follow-up period of 8.3 ± 4.6 months, 1 patient showed recurrent inflammation, which was successfully managed by a second round of TTO treatment.

CONCLUSIONS: Demodicosis should be considered as a potential cause of pediatric refractory blepharoconjunctivitis. Eyelid scrubs or massage with TTO could be an effective treatment regimen in these cases.

Cornea. 2010 Dec;29(12):1386-91.
Liang L, Safran S, Gao Y, Sheha H, Raju VK, Tseng SC.
Ocular Surface Center, Miami, FL 33173, USA.