Pilocarpine gel for the treatment of demodicosis--a case series

Optom Vis Sci. 1996 Dec;73(12):742-5. doi: 10.1097/00006324-199612000-00004.


Background: Excessive numbers of the mite, Demodax folliculorum, in the eyelash follicies cause itching and is referred to as demodicosis. We evaluated 4% pilocarpine gel as a treatment for this condition.

Methods: An advertisement was placed in a retirement home newsletter, requesting persons with ocular discomfort. Respondents were examined for Demodex and persons with abundant mites were invited to participate. One eye was treated with pilocarpine gel; the other eye was untreated. The relative abundance of mites was evaluated at baseline, after 1 and 2 weeks of treatment. Subjects kept a daily log of symptoms.

Results: Eleven of 22 persons with ocular itching had abundant Demodax. Mites were reduced significantly by the treatment (p = 0.017). The amount of mite reduction was closely correlated with the extent to which itching was alleviated (r = 0.811, p = 0.008).

Conclusion: Abundant Demodex is an important cause of ocular itching in older persons. Mites can be reduced with pilocarpine gel and itching alleviated.

MeSH terms

  • Administration, Topical
  • Aged
  • Aged, 80 and over
  • Animals
  • Eye Infections, Parasitic / drug therapy*
  • Eye Infections, Parasitic / etiology
  • Eyelashes / drug effects*
  • Eyelashes / parasitology
  • Female
  • Gels
  • Hair Diseases / drug therapy*
  • Hair Diseases / parasitology
  • Humans
  • Male
  • Mite Infestations / drug therapy*
  • Mite Infestations / etiology
  • Mites
  • Muscarinic Agonists / administration & dosage
  • Muscarinic Agonists / therapeutic use*
  • Ophthalmic Solutions
  • Pilocarpine / administration & dosage
  • Pilocarpine / therapeutic use*
  • Treatment Outcome
  • Visual Acuity


  • Gels
  • Muscarinic Agonists
  • Ophthalmic Solutions
  • Pilocarpine