Is this demodex, blepharitis or something else? (pics)

[Randolph]

I've posted these pictures before, but I have a new theory. What do you think this is:




I think it's demodex, because of it's similarity with this picture showing demodex (note that this picture is under some kind of unusual light and is of greater magnification):


(taken from: http://www.eyeworld.org/article.php?sid=4381)

But someone on a rosacea forum suggested it's blepharitis due to seborrheic dermatitis.

I don't have the benefit of a doctor checking for demodex. I've seen two and neither knew a thing about dry eye.

[irish eyes]

My eyelids are like all those in the pictures!

I have asked consultants about this and all responded by saying that Demodex infestation was a rare occurence and I didn't have it. Having said that - no-one has removed any eyelashes for analysis.

Some time ago, I read that the Body Shop brand of tea tree oil was worth trying if one suspected Demodex. It didn't make any difference at all other than to sting dreadfully - which I was willing to put up with if there was going to be a chance of improvement.

[littlemermaid]

Beautiful magnification photography

Your pictures are fantastic, beautiful detail. I want to examine eye surface for corneal neovascularisation, light from side, and similar base of eyelash (for same). Any advice?

I am currently assuming Demodex is common, overgrowth would be due to seb derm, unusual for Demodex to be cause of inflammation unless severe overgrowth. We use tea tree shampoo for seb derm scalp and it improves face while rinsing (not direct application on face, use it on upper torso tho'), eliminating Malassezia furfur (yeast) overgrowth (Tinea versicolor patches on forehead and upper back, occasional yellow scale flakes in eyebrows, behind ears, slight peeling skin on neck). Like you, I think it is correct to be nervous of tea tree oil (very lipophilic, applied neat kills mammals in research through skin) but very dilute it is amazing on 'beasties' of seb derm (as our dermatologist calls them).

You're thinking Demodex cause of inflammation reaction to bacteria, in littlemermaid's case I'm thinking yeast.

Your pics: if not Demodex, or our type of yeasty scale from seb derm, could be keratinisation from follicle. Does look like Demodex tho, doesn't it. I did get a private clinic quote for a Demodex check but decided not to bother, assuming most people have it, sticking with lid hygiene, assuming our MGD is blepharitis that is bacterial whatever the cause. Congrats again on amazing pics. You need a student friend in microbiology with access to some cool microscopes - I've found people like to be asked for advice.

[Randolph]

Your pictures are fantastic, beautiful detail. I want to examine eye surface for corneal neovascularisation, light from side, and similar base of eyelash (for same). Any advice?

I am currently assuming Demodex is common, overgrowth would be due to seb derm, unusual for Demodex to be cause of inflammation unless severe overgrowth. We use tea tree shampoo for seb derm scalp and it improves face while rinsing (not direct application on face, use it on upper torso tho'), eliminating Malassezia furfur (yeast) overgrowth (Tinea versicolor patches on forehead and upper back, occasional yellow scale flakes in eyebrows, behind ears, slight peeling skin on neck). Like you, I think it is correct to be nervous of tea tree oil (very lipophilic, applied neat kills mammals in research through skin) but very dilute it is amazing on 'beasties' of seb derm (as our dermatologist calls them).

You're thinking Demodex cause of inflammation reaction to bacteria, in littlemermaid's case I'm thinking yeast.

Your pics: if not Demodex, or our type of yeasty scale from seb derm, could be keratinisation from follicle. Does look like Demodex tho, doesn't it. I did get a private clinic quote for a Demodex check but decided not to bother, assuming most people have it, sticking with lid hygiene, assuming our MGD is blepharitis that is bacterial whatever the cause. Congrats again on amazing pics. You need a student friend in microbiology with access to some cool microscopes - I've found people like to be asked for advice.

littlemermaid, thanks for the compliments on the pictures. You seem to have posted a copy paste of another post, or parts of your post are, so it's a little confusing.

On demodex being common - I don't know how common it is, I know the incidence increases with age and I know that people can have it and not have symptoms.

The difference is in the amount of demodex and also in that different people respond differently. Person A can have a lot of demodex and have no symptoms, and person B can have little but have dry eye.

I'm not sure your statement on overgrowth of demodex being due to seb derm is correct.

I urge you not to discount demodex as a possibility, as I said, different people respond differently to it, so how common it is doesn't matter. The problem is, when you're sure that you have it what to do about it, because tea tree oil does the job, but, as you said, it is dangerous.

You say in your post "Like you, I think it is correct to be nervous of tea tree oil", I don't know if this means you've been reading my other posts or is this part of an older post of yours that you copy pasted, but in case you haven't seen it, I posted a thread a while back with a whole load of stuff I found on the internet taht is reported to kill demodex. The problem is it's hard to determine which of it is safe to apply to the eyes. Anyway, here's the thread (you'll also find confirmation that demodex causes dry eye there):

http://www.dryeyezone.com/talk/showthread.php?t=10668

on keratinization - I don't know much about keratinization I just remember seeing a picture of it a while ago, but it isn't related to DES is it? That could be it, but it seem kind of a long shot that I would have something unusual like whatever that is on the pictures and not have it be related to my DES.

On the pictures (though this is probably part of an old post and not directed at me ) - I took them at a resolution of 3072 x 2304, no zoom. The pictures there have been magnified on the computer, that's not the actual distance they were taken at. It can be a bit of a hassle to get the right distance and focus. As for pictures of the cornea I can't help you there. I highly doubt you'd be able to detect vascularization that way. A doctor can spot it with a slit lamp, but I don't know whether he has to be looking for it or whether it is immediately apparent.