Recent advances on ocular Demodex infestation

Curr Opin Ophthalmol. 2015 Jul;26(4):295-300. doi: 10.1097/ICU.0000000000000168.


Purpose of review: To summarize recent advances on ocular Demodex infestation.

Recent findings: Demodex infestation is a potential cause of ocular surface inflammation. The pathogenesis of Demodex in eliciting ocular surface inflammation has been further clarified. Cliradex is currently the treatment of choice, it comprises the most active ingredient of tea tree oil, that is terpinen-4-ol, which helps eradicate Demodex mites and reduce ocular surface inflammation.

Summary: Ocular demodicosis is a common but overlooked eye disease that manifests a number of morbidities. Demodex folliculorum causes chronic anterior blepharitis whereas Demodex brevis causes posterior blepharitis, meibomian gland dysfunction, recurrent chalazia, and refractory keratoconjunctivitis. The lash sampling and microscopic counting method and in-vivo confocal microscopy are key diagnostic methods. Cliradex shows promising potential to reduce Demodex counts with additional antibacterial, antifungal, and anti-inflammatory actions.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Anti-Infective Agents, Local / therapeutic use
  • Blepharitis / diagnosis*
  • Blepharitis / parasitology
  • Blepharitis / therapy
  • Eye Infections, Parasitic / diagnosis*
  • Eye Infections, Parasitic / parasitology
  • Eye Infections, Parasitic / therapy
  • Humans
  • Hygiene
  • Meibomian Glands / parasitology*
  • Mite Infestations / diagnosis*
  • Mite Infestations / parasitology
  • Mite Infestations / therapy
  • Mites
  • Tea Tree Oil / therapeutic use


  • Anti-Infective Agents, Local
  • Tea Tree Oil