ocular demodex, tea tree oil as a treatment

This recently published paper suggests that a variety of ocular symptoms might be caused by demodex infestation. Six patients all having demodex present, and suffering with recalcitrant symptoms (including 4 diagnosed with rosacea) were given tea tree oil for a weekly eyelid scrub and tea tree shampoo for a daily scrub. All patients showed a large decrease in demodex counts and relief from their symptoms.

Other recently published studies are showing that tea tree oil kills demodex. See ;

  • Clinical treatment of ocular demodecosis by lid scrub with tea tree oil., Cornea. 2007 Feb;26(2):136-43. Conclusions: Demodex potentially causes ocular surface inflammation, meibomian gland dysfunction, and lash abnormalities. Lid scrub with TTO can effectively eradicate ocular Demodex and result in subjective and objective improvements. This preliminary positive result warrants future prospective investigation of Demodex pathogenicity.
  • In vitro and in vivo killing of ocular Demodex by tea tree oil. [full text], Br J Ophthalmol. 2005 Nov;89(11):1468-73  Conclusions: Demodex is resistant to a wide range of antiseptic solutions. Weekly lid scrub with 50% TTO and daily lid scrub with tea tree shampoo is effective in eradicating ocular Demodex.

I have always pushed the line that demodex mites have thus far only been proven to be innocent bystanders in rosacea symptoms. In order to prove that the mites are responsible for some ocular symptoms we now need double blind studies to show 2 things – firstly that killing demodex does lead to a reduction in ocular rosacea symptoms and secondly some studies that show how tea tree oil works. We also now need larger studies that confirm that tea tree oil is a safe therapy for ocular symptoms.

Corneal Manifestations of Ocular Demodex Infestation, Kheirkhah A, Casas V, Li W, Raju VK, Tseng SC., Ocular Surface Center, Miami, Florida. Am J Ophthalmol. 2007 Mar 19

PURPOSE: To report the corneal manifestations in eyes with Demodex infestation of the eyelids.

DESIGN: Noncomparative, interventional case series.

METHODS: This retrospective review included six patients with Demodex blepharitis who also exhibited corneal abnormalities, which led to suspicion of limbal stem cell deficiency in three cases. All patients received weekly lid scrubs with 50% tea tree oil and a daily lid scrubs with tea tree shampoo for a minimum of six weeks. Improvement of symptoms and corneal and conjunctival signs were evaluated.

RESULTS: All six patients exhibited ocular irritation and conjunctival inflammation, while meibomian gland dysfunction (n = 5), rosacea (n = 4), and decreased vision (n = 3) also were noted despite prior treatments with oral tetracycline, topical steroids with antibiotics, and lid scrub with baby shampoo. These patients were proven to have Demodex folliculorum (n = 6) and Demodex brevis (n = 3) by microscopic examination of epilated lashes. Their corneal manifestation included superficial corneal vascularization (six eyes of five cases), marginal corneal infiltration (two eyes of two cases), phlyctenule-like lesion (one eye of one case), superficial corneal opacity (two eyes of two cases), and nodular corneal scar (two eyes of two cases). After treatment, the Demodex count was reduced from 6.8 +/- 2.8 to 1 +/- 0.9 (standard deviation; P = .001). All patients showed dramatic resolution of ocular irritation, conjunctival inflammation, and all inflammatory, but not scarred, corneal signs; three patients showed improved vision.

CONCLUSIONS: A variety of corneal pathologic features together with conjunctival inflammation, commonly noted in rosacea, can be found in patients with Demodex infestation of the eyelids. When conventional treatments for rosacea fail, one may consider lid scrub with tea tree oil to eradicate mites as a new treatment.

Further Reading ;


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