Blepharitis and Demodex: Myth or reality?

Purpose: Demodex folliculorum has been incriminated in the development of b lepharitis although much controversy persists. Certain authors suggest that Demodex is a direct pathogen in chronic palpebral conditions while others consider the saprophyte to be innocuous to skin. Methods: We conducted a prospective study of eyelashes in 100 persons, sear ching for Demodex foliculorum and chronic blepharitis. Microscopy in immers ion oil after storage in a moist chamber was performed. Results : The incidence of Demodex folliculorum was very high in patients w ith blepharitis compared with normal controls. Incidence increased with age . Harmless cuffs around the base of the eyelashes was found in 4% with Demo dex irradior. Conclusion: Demodex should be considered as the cause of chronic blephariti s. Anti-Demodex treatment is indicated when the parasite is found.