Demodex blepharitis is a highly prevalent and underdiagnosed ocular disease that affects ~58% of eye care patients in the US1-3,*

*Titan study: a retrospective chart review for Demodex blepharitis by 7 investigators at 6 eye care clinics of the case records of patients (N=1032) who underwent a slit lamp examination regardless of chief complaint.1

  • Prevalence
  • Patient Burden
  • Identification

Demodex Blepharitis

Demodex mites are associated with over two-thirds of blepharitis cases in the US, which are characterized by eyelid inflammation, redness, and irritation.1,2

Of the 45 million people who visit eye care clinics annually, ~58% have collarettes, the pathognomonic sign of Demodex blepharitis1,3

In the US

~25 million

eye care patients may have

Demodex blepharitis1,3

left side shape

Demodex blepharitis: highly prevalent, but underdiagnosed1-3

Titan study: a retrospective chart review for Demodex blepharitis by 7 investigators at 6 eye care clinics of the case records of patients (N=1032) who underwent a slit lamp examination regardless of chief complaint.1 The figures below were extrapolated using some of the data from the Titan study as well as other sources.

stat-people
stat-people
stat-people
stat-people
stat-people
1.5 Million

Blepharitis
w/Demodex
Diagnosed4

1.2 Million

Dry Eye Rx Patients
With Demodex1,5,6

2.2 Million

Cataract Patients
With Demodex1,7

2.3 Million

Contact Lens Intolerant Patients
With Demodex1,8

~18 Million

Demodex Patients Visiting
Eye Doctors3

stat-people
1.5 Million

Blepharitis
w/Demodex
Diagnosed4

stat-people
1.2 Million

Dry Eye Rx Patients
With Demodex1,5,6

stat-people
2.2 Million

Cataract Patients
With Demodex1,7

stat-people
2.3 Million

Contact Lens Intolerant Patients
With Demodex1,8

stat-people
~18 Million

Demodex Patients Visiting
Eye Doctors3

How Demodex mites cause blepharitis

Demodex blepharitis is caused by an infestation of Demodex mites, the most common ectoparasite found on humans. There are 2 species of Demodex—D. Folliculorum and D. Brevis—that live on the skin of the face and eyelids.1,2,9,10

Demodex folliculorum

Demodex
folliculorum

Demodex brevis

Demodex brevis

80%

of patients said Demodex blepharitis had a negative impact on their daily activities.3

Atlas study: A multicenter, observational, prospective, Institutional Review Board–approved study that included 311 patients with Demodex blepharitis aged ≥18 years. Demodex blepharitis was diagnosed based on the presence of ≥1.0 mite per lash (upper and lower eyelids combined), >10 collarettes on the upper lashes, and at least mild eyelid margin erythema of the upper eyelid in ≥1 eye. All patients were asked to complete a questionnaire about their symptoms, daily activities, and management approaches, and descriptive statistics were used to analyze the responses.3

woman checking her eyes in a mirror
Demodex blepharitis impact

In the Atlas study, patients experienced signs and symptoms of Demodex blepharitis for more than 4 years, including itchy eyes or dryness3

Demodex blepharitis can be hiding in plain sight1

Demodex blepharitis can be confidently diagnosed by looking for collarettes during a routine slit lamp exam. When present, collarettes are easily seen along the lash line of the upper eyelid margin when your patient looks down.

Slit lamp evaluation, 10x magnification Patient looking straight ahead in a slit lamp.
Patient looking straight ahead
Patient looking straight ahead with lid lift
Slit lamp evaluation, 10x magnification Patient looking down in a slit lamp.
Patient looking down, diffuse collarettes

100% of patients with collarettes have Demodex blepharitis.10

References

1. Trattler W, Karpecki P, Rapoport Y, et al. The prevalence of Demodex blepharitis in US eye care clinic patients as determined by collarettes: a pathognomonic sign. Clin Ophthalmol. 2022;16:1153-1164. 2. Fromstein SR, Harthan JS, Patel J, Opitz DL. Demodex blepharitis: clinical perspectives. Clin Optom (Auckl). 2018;10:57-63. 3. O’Dell L, Dierker DS, Devries DK, et al. Psychosocial impact of Demodex blepharitis. Clin Ophthalmol. 2022;16:2979-2987. 4. Symphony Health Claims Data. 5. Market Scope 2020 Dry Eye Products Report: A Global Market Analysis for 2019 to 2025. 6. White DE, Zhao Y, Ogundele A, et al. Real-world treatment patterns of cyclosporine ophthalmic emulsion and lifitegrast ophthalmic solution among patients with dry eye. Clin Ophthalmol. 2019;13:2285-2292. 7. Statement: American Academy of Ophthalmology and ASCRS Urge Aetna to Reverse Disruptive New Policy on Cataract Surgery. American Academy of Ophthalmology. Published July 1, 2021. Accessed August 22, 2023. https://www.aao.org/newsroom/news-releases/detail/aetna-urged-to-reverse-policy-on-cataract-surgery 8. Why contact lens wearers need their annual eye exam. Eye Health. Updated July 16, 2022. Accessed August 22, 2023. https://americanrefractivesurgerycouncil.org/contact-lens-problems-it-might-be-contact-lens-intolerance 9. Li J, O’Reilly N, Sheha H, et al. Correlation between ocular Demodex infestation and serum immunoreactivity to Bacillus proteins in patients with facial rosacea. Ophthalmology. 2010;117(5):870-877. 10. Gao YY, Di Pascuale MA, Li W, et al. High prevalence of Demodex in eyelashes with cylindrical dandruff. Invest Ophthalmol Vis Sci. 2005;46(9):3089-3094.

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