Pictured: One of the primary observations made by an eye-care professional is collarettes around the eyelashes, prompting further investigation of demodex.

Demodex infestation of the eyelids causes blepharitis. They have a life span of 2-3 weeks and lay about 15-20 eggs each in the eyelash hair follicle near the sebaceous glands. They consume epithelial cell cytoplasm by piercing through the cell membrane.

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Demodex is an 8-legged ectoparasite, meaning it lives on the surface of a host. It can live in hair follicles and sebaceous (oil) glands.

Blepharitis is a condition of eyelid inflammation that causes inflammation, as well as disruption in tear production.

Treatment

If Dr. Harry Boparai observes collarettes in a patient, he may recommend the use of a tea tree oil base in addition to scrubbing the eyelids. He may also recommend hypochlorous acid that can be used to mechanically wash the eyelids, with special attention paid to thorough cleaning technique because the mites can hide in hard-to-reach places.

A new treatment option from Tarsus Pharmaceuticals, the manufacturer of lotilaner ophthalmic solution 0.25% (Xdemvy), can be useful in promoting treatment adherence. Xdemvy is a prescription eyedrop used 2 times a day daily for 6 weeks.