High prevalence of Demodex spp. infestation among patients with posterior blepharitis: correlation with age and cylindrical dandruff

Arch Soc Esp Oftalmol. 2017 Sep;92(9):412-418. doi: 10.1016/j.oftal.2017.01.001. Epub 2017 May 25.
[Article in En, Spanish]


Objective: To determine prevalence of Demodex spp. and infestation index (II) by the parasite among patients of different ages with blepharitis and to assess association with occurrence of cylindrical dandruff (CC).

Materials and methods: Prospective study including patients diagnosed with posterior blepharitis between 2013 and 2015, without previous acaricide treatment, was conducted by Fundación Oftalmológica Los Andes (Chile). Four eyelashes were randomly extracted from each eyelid for parasite detection. The II was calculated as the ratio between the total number of demodex specimens found in the total number of eyelashes removed. A semi-quantitative determination of the CC was performed.

Results: A total of 178 patients (91 men, 87 women), with a mean age of 58.49±20.66 years, were included. It was found that 83.7% of patients were infested with Demodex folliculorum with a mean II of 0.96±0.84 mites/eyelash. The II was significantly higher in patients over 50 years (p<.0001). Patient age and II showed a Pearson correlation coefficient (R2) of 0.12 (p<.0001). CC was observed in 71.4% of patients, with those over 50 years-old showing significantly higher values. A positive correlation was also observed between the amount of CC and the II (R2=.33; p<.0001).

Conclusions: The prevalence of infestation by Demodex folliculorum is high in patients with posterior blepharitis. The II by the parasite is positively correlated with age and with the occurrence of CC on the eyelid border.

Keywords: Blefaritis; Blepharitis; Caspa cilíndrica; Cylindrical dandruff; Demodex brevis; Demodex folliculorum; Infestation index; Índice de infestación.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Animals
  • Blepharitis / parasitology*
  • Child
  • Dandruff / parasitology*
  • Dandruff / pathology
  • Eyelashes / parasitology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mite Infestations / epidemiology*
  • Prevalence
  • Prospective Studies
  • Young Adult