Demodex blepharitis-blecch

[Raj]

Demodex are the actual critters themselves. They live in the sebaceous (oil) glands of the eyelid. Their activity and waste products cause inflammation of the gland, and reduce its oil output, which the patient experiences as blepharitis and evaporative dry eye. The difference between demodex and blepharitis is thus one of cause and effect.

The probability of a significant infestation increases with age, which is why, in the study on pilocarpine gel above, the researchers recruited retirement home subjects. The retirement home provided a convenient place to find subjects. Demodex also live on dogs and cats (mostly dogs), but apparently, transmission from dogs and cats to humans is apparenty rare (see http://www.thepetcenter.com/exa/dem.html). Each species of mite tends to infect one kind of host animal.

Raj

[Kyle]

I'm sorry...am I the only one that is truly disgusted by even the thought of that!?
I seriously can't even think about those creatures, because I would just constantly throw up.
Thanks for clearing that up though.

[jcorbett]

Sooooo....

So demon-dex (my term for them) can cause blepharitis, but you can also have blepharitis without demon-dex? Or not?
I've had blepharitis before....at least that's what the doc says....all they gave me was erythromycin and it went away????

[Raj]

Demodex is one cause of blepharitis, yes. There are many kinds of blepharitis, and I doubt that physicians agree on the various subdivisions that have been proposed.


This link gives a good overview of the various kinds. It also shows pictures associated with the various kinds, such as eyelashes encrusted with morning crusties. Maybe someone will see themselves there.

http://www.ophthalmic.hyperguides.co...s/tutorial.asp

Here's a link to Table 1 from that article, which illustrates how various signs and symptoms are involved with anterior (front of your lids, which you clean with lid scrubs) and posterior (under the lid, which you palpitate to release oil) blepharitis.

http://www.ophthalmic.hyperguides.co...des/table1.gif

Note also that the various kinds of blepharitis are sometimes associated with other skin (dematologic) issues.

Raj

[Lucy]

Gross

I think these pictures should be shown at lasik seminars. Can you imagine how grossed out possible patients would be?"

We didn't know we'd need a termite exterminator after lasik.

[Kyle]

Although I'm laughing right now at Lucy's response...I have to totally agree!
Remember, I've said this before elsewhere on this website, I did NOT want the surgery. Everyone, including my eye surgeon himself, kept telling me there would be NO problems whatsoever. "Oh no, we do this surgery ALL the time!". Now, I can't drive at night, I have pain in my eye constantly, and I have critters living off of my eyelids...that is even beyond gross.
And no Erik, I'm not feeling sorry for myself (at least not anymore). I have learned to live and accept my condition (although it took me a long time), but I totally agree that ALL possible complications should have been discussed at length with each and every one of us..instead of merely brushing issues like that aside!

[ajneedhams]

I'm confused with which way to treat for Demodex.

Some article said that Polymixin/Bacitracin or erythromycin would work. That might help with the waste products, but it is my understanding that a completey different antibiotic like Flagyl needs to be administered. This med kills living protozoans and bug critters. (sorry, I'm not too technical here) I was told that regular antibiotics would not work.

This Pilocarpine gel. I assume that is an RX. What does it do? do opths or derms prescrible that?

I have also heard of Ivernectin which is routinely used in horses and now people are using it with good results as well. It is oral of course.

I'm not sure what to try? I never thought that switching my shampoo to Tea Tree shampoo and tea tree extract would do the trick. Seems to topical and simple. I thought these buggers lived deep down.

Any thoughts on the various treatments?? Anyone else trying one and having great results?

Amy

[Raj]

Here's what we need: http://www.visionsimulations.com/XT.jpg

If you search Pubmed at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi for "Demodex" and the names of the various medications you mentioned, you'll come up with some research. Some of the meds seem to be more effective or well researched than others. Not sure which ones might be specific or effective on the face, and which ones might be specific or effective for the eye.

Commonsense would say that if demodex is on your face, and is left untreated, then it will re-contaminate your eyes.

Raj
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J Dermatol. 2004 Aug;31(8):610-7. Related Articles, Links


Efficiency of benzoyl peroxide-erythromycin gel in comparison with metronidazole gel in the treatment of acne rosacea.

Ozturkcan S, Ermertcan AT, Sahin MT, Afsar FS.

Department of Dermatology, Medical Faculty of Celal Bayar University, Manisa, Turkiye.

Oral wide-spectrum antibiotics are the linchpin of rosacea treatment. Oral and topical metronidazole, topical tretinoin, and topical benzoyl peroxide may also be used in the treatment of rosacea. We aimed to show that benzoyl peroxide-erythromycin gel is efficient in the treatment of acne rosacea. Fifty-six patients with acne rosacea were enrolled in our study. We administered benzoyl peroxide-erythromycin gel to 27 patients and metronidazole gel to 29 patients. In all the patients, the intensities of erythema, telangiectasia, papules/pustules, and nodules were evaluated before, during and after the treatment. The positivity of Demodex folliculorum from skin scratches was compared between the two groups at each visit. At the end of the therapy on the third examination, in the benzoyl peroxide-erythromycin group, 91.7% of the patients showed marked clinical improvement, and 8.3% of them showed complete remission. In the metronidazole group, 73.3% showed marked clinical improvement, and 26.7% of them showed complete remission. Clinical improvement in the papular component was 65.2% for the benzoyl peroxide-erythromycin group, and 81.5% for metronidazole group. In the first examination, the clinical results of the agents were similar. Although both of the drugs were found to be effective in the second and third examinations, metronidazole gel was more effective than benzoyl peroxide-erythromycin. Both of the drugs were found to be significantly effective especially in treating the papular component of rosacea. Demodex folliculorum was found to be positive in 74.1% of the benzoyl peroxide-erythromycin group and in 62.1% of the metronidazole group at the beginning. In the benzoyl peroxide-erythromycin group, 40.7% of Demodex folliculorum positive patients, became negative by the first examination. This was 17.2% for the metronidazole group. In the benzoyl peroxide-erythromycin group, among the patients who were positive for Demodex folliculorum in the first examination, 37.5% of them became negative. This was 36.7% for the metronidazole group. Benzoyl peroxide-erythromycin gel was superior to metronidazole gel in decreasing Demodex folliculorum by the first examination, but the effect of the two drugs on Demodex folliculorum was similar by the second examination. As a result, topically applied combined benzoyl peroxide-erythromycin gel may be an alternative choice of treatment for acne rosacea.

[Lucy]

A New Career?

Some one looking for a new career? A Demodex Terminator!

Good vision required.

Raj......that pic is hilarious.

[Cindy]

By Luce:

Raj......that pic is hilarious.

Yes it is!! I really enjoy the humor on this bb! There are some really funny posts and posters with a knack for giving me a big grin (Lucy & Dianat in particular). I get a kick out of all of them .

[dianat]

Thanks for the pic, Raj. I needed that...

[Raj]

hehe...glad that good for a laugh. I should have put in some of the little critters crawling around.

Raj

[dianat]

I read an article once about how demodex copulate. I laughed at how much could be going on right in front of our very eyes! Certainly that fact would lend itself to a most hilarious graphic. Appropriate? Probably not. But it could be darned funny...

[linmis]

demodex solutions

In reply to Maurie, I also found this web site (http://www.demodexsolutions.com/) after just recently being diagnosed with demodex induced blepharitis. I found the web site to be helpful and while not sure of the products yet, it certainly is worth looking into. Bacitracin and lid scrubs with baby shampoo certainly didn't get rid of my parasites or help my dry eye over the last 2 years. I'm going to try tea tree oil in the meantime.

[homes]

Demodex was most certainly NOT listed on my informed consent form!


Diana

consent form? WHAT consent form? god bless third world countries! ha.