Continuing with bugs: after ticks, mites

Blog vol 4.5. Continuing with bugs: after ticks, mites.

I spent a couple weeks on the topic of ticks and preventing Lyme Disease. Now we look at the world of mites, specifically the Demodex folliculorum which takes up residence in the roots of the eyelashes. Two recent articles in ophthalmology journals have focused on this topic.

Demodex folliculorum are very tiny (adults are about 3/10mm), eight-legged parasites that mate then lay eggs in the hair follicles of the eyelashes. These larvae hatch within 3-4 days and reach adulthood after 7 days. This sounds disgusting but is not all bad as mites can be helpful getting rid of dead skin and excess oils, their main source of food. When they die they usually break down inside the follicles.  Some estimates have up to 20% of the general population with these critters and up to 65% of the elderly.   

The word of the day is “EXCESS”: (1) an amount of something that is more than necessary, permitted, or desirable. (2) lack of moderation in an activity, especially eating or drinking (or in this case hosting too many mites). (3) exceeding a prescribed or desirable amount. (Oxford dictionary)

These mites can live symbiotically in our lashes as long as they do not go crazy. An excess of mites will cause red itchy lids, blurry vision, and even eye lash loss (a nasty form of blepharitis). 

One journal article linked cataract surgery to an increase in infestations, reminding surgeons to be on the look-out for this condition after surgery (see article here).

Another article discussed the results of a double-masked study that looked at the efficacy of a new eye drop: Lotilaner. When used twice a day for 6 weeks it has substantial results against the mite (read article here).

The traditional method of treatment is to use warm compresses for the swelling and to clean the lids thoroughly and regularly, even scrubbing to get rid of dead skin. More recently, low dose tea tree oil wipes like Blephadex have been used to kill the adults and the growing larvae. This has to be done over a 3 week window because of the mite’s life cycle. My best guess is that the new Lotilaner eye drop will have good results because patient compliance will be higher than for traditional treatments, but that for the best results, cleaning and regular hygiene, though cumbersome, are unavoidable.

So, if you are having irritated, sore eyes and eyelids please come in and see us, we just “mite” be able to help you. 

‘til next week,



the good doctor