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Demodex species in human ocular disease: new clinicopathological aspects


Nicholls, SG and Oakley, CL and Tan, A and Vote, BJ, Demodex species in human ocular disease: new clinicopathological aspects, International Ophthalmology, 37, (1) pp. 303-312. ISSN 0165-5701 (2017) [Refereed Article]

Copyright Statement

Copyright 2016 Springer Science+Business Media Dordrecht

DOI: doi:10.1007/s10792-016-0249-9


Demodex brevis and Demodex folliculorum are likely ubiquitous organisms associated with human eyelashes. However, they have also been implicated in the pathogenesis of external ocular diseases. This article reviews the current literature in regards to life cycle, morphology, pathogenesis and treatment of underlying Demodex spp. infestation and outlines the previously undescribed in vivo behaviour of the mites. Images were obtained from the epilation of lashes from 404 patients seen in clinical practice. Epilated lashes were placed on a microscope slide which had been coated with optically clear hypromellose/carbomer gel (Genteal gel, Novartis pharmaceuticals corporation, East Hanover, New Jersey). Adults were identified with either dark field or standard transmission microscopy at 40-100. Eggs and other life-cycle stages were examined at 250 magnification, with transmission microscopy giving the best image resolution. The life cycle of the mite has been reviewed and simplified according to clinical observations. Clinical signs suggestive of underlying Demodex spp. infestation have been described, and their pathogenesis was explained based on the micrographic digital images obtained. The problem of symptomatic Demodex spp. disease likely reflects an imbalance in the external ocular ecology; however, the role of Demodex spp. as a commensal should not be overlooked. Treatment should not be aimed at total eradication of the mite but rather restoring the ocular ecology to a balanced state. By revisiting the life cycle of the mite, we can identify areas where possible intervention may be effective.

Item Details

Item Type:Refereed Article
Keywords:Demodex, dry eye disease, external ocular disease, blepharitis
Research Division:Biomedical and Clinical Sciences
Research Group:Ophthalmology and optometry
Research Field:Ophthalmology
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Nicholls, SG (Dr Stephen Nicholls)
ID Code:116755
Year Published:2017
Web of Science® Times Cited:42
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-05-18
Last Modified:2018-06-01

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