written by Dr. William McSwain
Demodex blepharitis is a common source of eyelid inflammation and ocular irritation. It is caused by the demodex mite. The presence of demodex increases with age making them present in the vast majority of people over 70 years of age. While most people have demodex living on their eyelid skin and in their eyelashes, they usually are not symptomatic. Symptoms of demodex blepharitis include eyelid itching, burning, foreign body sensation, crusting, redness, and exacerbation of dry eye which can lead to blurry vision.
Lid hygiene with warm compresses and lid scrubs with Tea Tree Oil is the most effective treatment. If you follow this regiment 1-2 x daily consistently for 3-4 weeks, your symptoms should improve to the point that you only need to perform lid hygiene on an as needed basis.
- Warm compresses: Take a wash cloth and run it under warm water. Press the wash cloth against your eyelids for at least 5-10 minutes 2 x daily. You may have to reheat the wash cloth during this time if it cools off. The heat and moisture will open up the oil glands in your eyelids. You can also gently massage the oil glands during this time to clear any blockages.
- Lid scrubs with tea tree oil: After doing warm compresses, gently scrub your eyelashes with a Tea Tree Oil cleanser for 45-60 seconds. Tea Tree Oil is the only effective way to kill demodex mites. I recommend using Oust Demodex Cleanser. After allowing the tea tree oil to work for 45-60 seconds, rinse it off your eyelashes and eyelids with warm water. Alternatively, Cliradex lid scrubs may be purchased from a pharmacy or online here.