Ocular demodicosis as a potential cause of pediatric blepharoconjunctivitis

Cornea. 2010 Dec;29(12):1386-91. doi: 10.1097/ICO.0b013e3181e2eac5.


Purpose: To report Demodex infestation in pediatric blepharoconjunctivitis.

Methods: A retrospective review of 12 patients, with ages from 2.5-11 years, with chronic blepharoconjunctivitis who failed to respond to conventional treatments. Demodex was detected by lash sampling and microscopic examination. Patients were treated with 50% tea tree oil (TTO) eyelid scrubs or 5% TTO ointment eyelid massages for 4-6 weeks.

Results: Demodex mites were found in all, but 1 case had cylindrical dandruff in the lashes. After 1 week of TTO treatment, all patients showed dramatic resolution of ocular irritation and inflammation while Demodex counts dropped. All corneal signs resolved within 2 weeks except for a residual anterior stromal scar in 1 eye. During a follow-up period of 8.3 ± 4.6 months, 1 patient showed recurrent inflammation, which was successfully managed by a second round of TTO treatment.

Conclusions: Demodicosis should be considered as a potential cause of pediatric refractory blepharoconjunctivitis. Eyelid scrubs or massage with TTO could be an effective treatment regimen in these cases.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Infective Agents, Local / therapeutic use
  • Blepharitis / diagnosis
  • Blepharitis / drug therapy
  • Blepharitis / parasitology*
  • Child
  • Child, Preschool
  • Chronic Disease
  • Conjunctivitis / diagnosis
  • Conjunctivitis / drug therapy
  • Conjunctivitis / parasitology*
  • Eye Infections, Parasitic / diagnosis
  • Eye Infections, Parasitic / drug therapy
  • Eye Infections, Parasitic / parasitology*
  • Eyelashes / parasitology
  • Female
  • Humans
  • Male
  • Massage
  • Mite Infestations / diagnosis
  • Mite Infestations / drug therapy
  • Mite Infestations / parasitology*
  • Mites / pathogenicity
  • Retrospective Studies
  • Tea Tree Oil / therapeutic use


  • Anti-Infective Agents, Local
  • Tea Tree Oil