• About Us
  • Privacy
  • Contact Us

Contact Lens Update

Clinical Insights Based in Current Research

Search Our Site

  • Home
  • Browse Past Issues
  • Resource Library
  • Back to Basics
  • Useful Links
  • About Us
  • Contact Us

Conference Highlights

A case of mistaken blepharitis identity: staph or demodex?

February 17th, 2015
Etty BittonEtty Bitton, BSc, OD, MSc is an Associate Professor and Director of the Dry Eye Clinic at the Université de Montréal. Her research interests include tear film evaluation, dry eye and its effects on contact lens wear.

Download the poster (.pdf), which was originally shared at the British Contact Lens Association (BCLA) Clinical Conference and Exhibition, 2014.


A CASE OF MISTAKEN BLEPHARITIS IDENTITY: STAPH OR DEMODEX?
Etty Bitton OD, MSc, FAAO, FBCLA, Samantha Kronish
Universite de Montreal, Montreal, Quebec, Canada

Purpose: Anterior blepharitis is usually caused by a staphylococcus aureus (SA) infection, and expressed clinically as “crusty debris” on inflamed lid margins. Conventional therapy includes antibiotics to reduce the bio-burden. When patients are unresponsive to treatment, one must look at other potential causes. A meticulous observation of the type of debris and its placement on the eyelash may give us a clue. SA-blepharitis has golden yellow crusting at the base of the lash which progresses along the lash when it grows. Demodex, on the other hand, is a parasite, giving rise to gelatinous debris, which surrounds the base of the lash, described as a dandruff cuff (DC). The Demodex mites are light sensitive so their heads are buried in the lash follicle with only their tails visible at the eyelash base. Their small size makes them difficult to identify with a biomicroscope, hence only epilation of lashes with DC and observation under a micros cope confirms the diagnosis. The true prevalence of Demodex is unknown but is reported to be abundant in the elderly.

This report describes 3 cases presenting with dry eye (DE) symptoms including discomfort and mild itching, which at first was mistaken for SA-blepharitis and turned out to be Demodex infestation. The case provides an overview of the Demodex mite, its clinical presentation and examination technique and tea tree oil-based treatment options. It has been reported that Demodex may be more common than we think and clinicians should consider it in their differential diagnosis of any ocular discomfort.

Related Articles

  • February 17, 2015

    A case of mistaken blepharitis identity: staph or demodex?

  • February 17, 2015

    The significance of eyelid conditions for patients

  • February 17, 2015

    Identifying Demodex in the eyelash follicle without epilation

  • February 17, 2015

    Meibomian gland disfunction and Demodex: A tale of two mentors

Issues

  • In-Office Procedures for Dry Eye
  • Multifocal Contact Lenses
  • Artificial Tears: An Update
  • Myopia: New Evidence and Best Practices
  • Neuropathic Pain
  • Specialty Rigid Lenses
  • Contact lens compliance
  • Pandemic update
  • Digital Devices and Dry Eye: A Growing Issue
  • The long and short of axial length
  • Using BCLA CLEAR with your patients
  • Helping your patients through allergy season
  • Getting the measure of meibomian glands
  • 2020: An extraordinary year
  • Scleral lens update
  • A dose of myopia
  • New news since TFOS DEWS II
  • COVID-19 Special Edition
  • Material considerations
  • Putting dry eye theory into practice
  • Getting started with Ortho-K
  • Infiltrates – an update
  • Staining
  • Myopia matters: Summarising the IMI reports
  • Lids and contact lenses
  • Myths
  • Revisiting patient compliance
  • Contact Lenses & Kids
  • Interprofessional Collaboration
  • Digital eye strain
  • New Dry Eye Technology
  • Update on Presbyopia
  • Taking stock of dry eye disease: DEWS II
  • Scleral Lenses
  • Pain and Sensation
  • Lab measurements in clinical practice
  • Control of pediatric myopia
  • Nutrition
  • Rethinking contact lens deposits
  • Extended wear
  • Daily Disposables
  • Eyelash Mites (Demodex)
  • Outsmarting bacteria with new technology
  • Youth and contact lenses
  • Sports Vision
  • Ocular effects of UV radiation from the sun
  • Eyelid Conditions
  • Makeup: Impact on ocular health
  • Myopia Control – Update 2014
  • The Growing Prevalence of Myopia
  • Cosmetic contact lenses
  • Contact lens discomfort – The essentials
  • Technology and contact lens research
  • It's A Question of Comfort
  • Contact lens materials
  • Let's talk about SICS
  • Conjunctival Controversies
  • Kids & Contact Lenses
  • One-day silicone hydrogel lenses
  • Solutions
  • Spotlight on Scleral lenses
  • Drug delivery via contact lenses
  • Ocular allergies
  • Reducing lens case contamination
  • Dry eye and meibomium gland dysfunction
  • Myopia Control
  • Presbyopia
  • Compliance and non-compliance
  • Lens care
  • Celebrating 50 years of contact lenses

Looking for another article?

Alcon coopervision Johnson&Johnson Vision Care

Newsletter Sign-Up

Sign-up for and start receiving our newsletter.

Site Map

  • Home
  • Browse Past Issues
    • Editorial
    • Feature Article
    • Clinical Insight
    • Conference Highlights
  • Resource Library
  • Back to Basics
  • Useful Links
  • About Us
  • Contact Us
© 2023 Contact Lens Update