Can a 3 year old have demodex mites in eyelashes?

[tiff]

My daughter has some kind of "crud" at the base of her upper eyelashes. I've tried ocusoft foam plus and a warm washcloth several times and cannot remove whatever is there. She doesn't complain about it, but it worries me because I have blepharitis and my son has dry eyes and complains of them all the time. My daughter doesn't complain about her eyes, but I see her rubbing them a lot.

Is it possible for a child her age to have demodex mites? I've looked online and can't tell if what is at the roots of her eyelashes are these mites. If they are, how can we get rid of them? thank you.

[littlemermaid]

Hi Tiff, Search PubMed and Medscape for the latest info, and take a look at Dr Scheffer Tseng's work with children http://www.ncbi.nlm.nih.gov/pubmed/20847679
Cornea. 2010 Dec;29(12):1386-91. Ocular demodicosis as a potential cause of pediatric blepharoconjunctivitis. Liang L, Safran S, Gao Y, Sheha H, Raju VK, Tseng SC. Source Ocular Surface Center, Miami, FL 33173, USA.

If it was me I would email Dr Scheffer Tseng direct for advice on how he would treat this. Why not. Plus, can you send Dr Tseng photographs? - get your optometrist to take a photograph of the eyelash bases through the ophthalmoscope? plus photograph the eye surface with fluorescein dye in if possible so he can see the tear film? plus any 'telangiectasia' ie tiny red squiggly veins and redness on the eyelid margins?

We can't actually see the mites (Demodex folliculorum and Demodex brevis), only the cylindrical 'dandruff' at the base of the eyelashes. If there is debris around the eyelash base anyway, I've always assumed demodex and other bugs move in and that is why we all clean so carefully and use warm compresses to keep things good.

We get rid of Demodex mites gently with very dilute tea tree oil solutions http://www.eyeworld.org/article.php?sid=4381. Here Dr Tseng recommends 50:50 TTO and macademia nut oil, but I have a paediatric ophthalmologist on the job and he thinks that's too harsh for children and builds sensitivities to the tea tree oil.

For children, mine is using 1:50 TTO shampoo (organic) diluted in warm water as a gentle eyelid cleaner. Use a cotton bud or cotton wool swab to get right into the eyelash bases. We've had big improvement on this for the blepharitis, partly because it improved our cleaning regime. There was no stinging. We used this solution for 4wk, then reduced to weekend only to avoid future problems.

This more careful regime might be helpful - I remember your family are allergic. It's easy to get sensitive to TTO products so we're trying to avoid the eyes getting sore on them. We also change pillowcases and undersheet frequently, and I wash and iron them very hot.

Although we've attempted to test twice for demodex etc by pulling eyelashes, we've never managed to find much. If you read more of Dr Tseng's work he explains why this is, that it's difficult to get the little b*s out of the follicle, onto the eyelash and then onto the slide (see Hankm's fantastic video from Dr T's office).

I understand all the children's eye clinics in the US accept demodex in children now and can recommend treatments. I would write to the Cornea service at your nearest major children's hospital or eye hospital with paediatric service for advice. Maybe get your ophthalmologist to have a look at the latest research and come up with some support.

None of this means that you or the little fella or his sister have demodex problems though. But if you want a safe regime, ours has been good (I'll tell you whose regime it is if you PM me - he might email you back).

[tiff]

Thank you so much, little mermaid! I will look into all of your advice.

Do you happen to know what other reason would cause a little clogging at the base of some of her eyelashes on the upper lid margin? These clogs are not milia or clogged meibomian glands, but it looks like the follicle is clogged. This area is not red, but it looks like the skin kind of protrudes onto her eyelash bases in a few areas moreso than anywhere else or compared to the way eyelashes normally look. The whites of her eyes are pink if you look at them carefully. I really envy the children who have white eyes with no red veins like my children have constantly. The kind my kids have don't go away. I'll make an appointment with a pediatric opthamologist for her as the optho my son has been seeing doesn't really think any of his issues are worth managing with anything but warm compresses and drops.

Hi Tiff, Search PubMed and Medscape for the latest info, and take a look at Dr Scheffer Tseng's work with children http://www.ncbi.nlm.nih.gov/pubmed/20847679
Cornea. 2010 Dec;29(12):1386-91. Ocular demodicosis as a potential cause of pediatric blepharoconjunctivitis. Liang L, Safran S, Gao Y, Sheha H, Raju VK, Tseng SC. Source Ocular Surface Center, Miami, FL 33173, USA.

If it was me I would email Dr Scheffer Tseng direct for advice on how he would treat this. Why not. Plus, can you send Dr Tseng photographs? - get your optometrist to take a photograph of the eyelash bases through the ophthalmoscope? plus photograph the eye surface with fluorescein dye in if possible so he can see the tear film? plus any 'telangiectasia' ie tiny red squiggly veins and redness on the eyelid margins?

We can't actually see the mites (Demodex folliculorum and Demodex brevis), only the cylindrical 'dandruff' at the base of the eyelashes. If there is debris around the eyelash base anyway, I've always assumed demodex and other bugs move in and that is why we all clean so carefully and use warm compresses to keep things good.

We get rid of Demodex mites gently with very dilute tea tree oil solutions http://www.eyeworld.org/article.php?sid=4381. Here Dr Tseng recommends 50:50 TTO and macademia nut oil, but I have a paediatric ophthalmologist on the job and he thinks that's too harsh for children and builds sensitivities to the tea tree oil.

For children, mine is using 1:50 TTO shampoo (organic) diluted in warm water as a gentle eyelid cleaner. Use a cotton bud or cotton wool swab to get right into the eyelash bases. We've had big improvement on this for the blepharitis, partly because it improved our cleaning regime. There was no stinging. We used this solution for 4wk, then reduced to weekend only to avoid future problems.

This more careful regime might be helpful - I remember your family are allergic. It's easy to get sensitive to TTO products so we're trying to avoid the eyes getting sore on them. We also change pillowcases and undersheet frequently, and I wash and iron them very hot.

Although we've attempted to test twice for demodex etc by pulling eyelashes, we've never managed to find much. If you read more of Dr Tseng's work he explains why this is, that it's difficult to get the little b*s out of the follicle, onto the eyelash and then onto the slide (see Hankm's fantastic video from Dr T's office).

I understand all the children's eye clinics in the US accept demodex in children now and can recommend treatments. I would write to the Cornea service at your nearest major children's hospital or eye hospital with paediatric service for advice. Maybe get your ophthalmologist to have a look at the latest research and come up with some support.

None of this means that you or the little fella or his sister have demodex problems though. But if you want a safe regime, ours has been good (I'll tell you whose regime it is if you PM me - he might email you back).

[Lucy]

If a child has demodex, is it possible they might get them from contact with other children? I don't know if your 3 year old has siblings, or is in pre-school or babysitter with other children, but so many things go between children--that's something to ask too. In case you cleared it up and she got them again in the same environment. I may be way off, but I know someonw with several children and some are in elementary school and they have had a problem with lice. She is having a terrible time clearing them up. I think the problem is that it's not necessarily the lice that creates the problem, but the nits that attach to the hair. That may be a bad example, but just showing how little ones spread disease among themselves.

Good luck in your pursuit. Lucy

[littlemermaid]

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946818/
Curr Opin Allergy Clin Immunol. 2010 October; 10(5): 505–510. doi:10.1097/ACI.0b013e32833df9f4 PMCID: PMC2946818 NIHMSID: NIHMS232255 'Pathogenic role of Demodex mites in blepharitis' Jingbo Liu, Hosam Sheha and Scheffer C.G. Tseng

This is a good summary article to print out (download as .pdf) and give to your ophthalmologist (some ophth are still not up to date, although I think the US paed ophths might be OK with this now at last). There's also useful links to the right. The dead skin/sebum at the follicle base is called 'collarettes' or 'cylindrical dandruff', if you want to Google some more.

http://www.healio.com/optometry/corn...doctor-patient Here are good pictures of the eyelash base clogging - article by Mario Gutierrez from Primary Care Optometry News June 2011. Another print out for the ophth. As this advice, I hot-wash and iron the bedding too, and we are all careful to use separate towels. It's useful to have many cotton flannels for the children so that they can use a fresh towel every time to wash and dry their faces.

Do you happen to know what other reason would cause a little clogging at the base of some of her eyelashes on the upper lid margin?

I've always thought it was normal sebum oil and dead skin since it's a hair follicle. It's useful to look at other kid's eyelashes if you can manage it. It's amazing what goes on in terms of styes and clogged glands and flaking that's normal and part of the body's cleaning programme. Does she have any flakey dandruff on her scalp or behind her ears or any eczema? Yes, we get oversensitive to our children's eyes but with good reason. If there's chronic red eye you need support and advice.

I'd be thinking about the allergies too and asking the ophthalmologist to look carefully for allergic responses as well (cherry red possibly lumpy underneath eyelids). If there's eyelid margin inflammation causing problems, it could be a delayed hypersensitivity response (type IV) rather than the common allergic type 1 reaction. We're really careful to use minimum and hypersensitive bathroom and cleaning products, just the simplest soap and water in the bath.

And we need to be very careful what eye cleaning to use so as not to make the eyes sore and over-reactive. At our paed hospital they don't generally use products or eg baby shampoo on the eyes, only warm water. Although now my daughter is teenage, her eyes can tolerate more products in the short term without reacting.

We clear the clogged follicles as well as the other oily glands on the eyelid margins with warm compress in bath/shower, and the 4wks of very dilute organic TTO shampoo has cleared it all very well, but it comes back pretty fast if we neglect things, although we are down to 1/wk as a preventative without setting up long-term sensitivity to TTO.

(We also wipe the solution around the eye socket and nose and mouth but that's because she has periorificial dermatitis so I'm sure demodex enjoy that. TTO shampoo is too harsh to use on the hair often but it hasn't hurt maybe once/twice per week - as Lucy mentions the inevitable headlice, any mother dealing with that probably uses TTO conditioner to fine-comb them out and a children's TTO shampoo occasionally just in case it helps put them off.)

Quite what collarettes are or what they're a sign of, let's hope Dr Tseng will establish. Of course, virtually everyone over 10yo has demodex normally. As above, I think it's about whether they're in overgrowth and whether people are sensitive/allergic to them or the bacteria they pump out (Bacillus oleronius), as the article.

It's gross, I know, but OK once you get used to the idea we do not live alone anyway, and it's about a happy cleaning and maintenance regime, and we have amazing immune systems to support. I would think about this without any certainty or panic, but as just another factor to prevent in the joys of blepharitis. Wish you the best, Tiff - hope you can find good well-read eye doc support.

(PS no way would I allow oral insecticide in a child unless there was massive co-morbidity so think many many times if some dopey doc suggests trying eg oral ivermectin.)

Hi Queen Lucy ~ good to have you back

If a child has demodex, is it possible they might get them from contact with other children

More likely to be an adult. Used to be thought not transferable from pets (very common on some dog breeds esp immunocompromised or nutritional deficiency), but now they think it is. Gross, but fascinating

[MeibomianGlandman]

Demodex

DEMODEX ARE POSSIBLE!

Blepharitis I believe is Caused by Seborrheic dermatitis of the Scalp. AKA infected Dandruff, by yeast and bacteria.

Go See a Dermatologist immediately and wash those bedsheets and pillowcases!

You might need ketoconazole shampoo! If the scalp itchy or oily.

Also Demodex Don't like ocusoft eyelid foam cuz it does have small amounts of tea tree oil in it!!! Trust me Been to a specialist under a microscope did confirmed it worked...they were all but gone!

Also if it don't work, You can drown them in Jojoba Oil on the closed eyelids every night they get stuck in that stuff!

Also Please Check your Self for allergies! That's a Big cause of Blepharitis!
That means if your head itch after you use that new shampoo it could be causing the problem, check soap and shampoo labels for preservatives, polyquaternium, Some are sensitive to Tide Laundry detergent!

Also Make sure You don't have a Mold Problem in your House!!! AKA musty smell, black patches on the walls, weird perfume smell. Those are myco toxins, DEADLY!!! Been through that almost died, do not take lightly if your family having sinus problems.

Mold is the Nightmare substance that Causes a host of health problems, and led to my Dry Eye.

But It was the Yeast that was from that mold infestation that got on my head, caused infection which i didn't know about from the shampoo I was using, and then got in my eye from pillow case! Causing blepharitis and then Dry Eye after antibiotics and steroids!

Best Advice I can give...Do what you can, Blepharitis is the beginnings of dry eye...Stay on this site...be weary of meds.

[MeibomianGlandman]

When I say Be Weary of meds Watch out for antihistamines and Decongestants this stuff can cause dry eye.