Multidisciplinary perspectives in <i>Demodex</i> blepharitis: A new view of treatment from clinical, payer, and patient perspectives.

Abstract

<i>Demodex</i> infestation is the cause of more than two-thirds of all cases of blepharitis in the United States. Although symptoms may include crustiness, redness, or itching of the eyelids, diagnosis can be accomplished through a simple examination of the eyelashes. The presence of a waste product of the <i>Demodex</i> mite, known as collarettes, on the base of the eyelashes is a pathognomonic sign of <i>Demodex</i> blepharitis. <i>Demodex</i> infestation that results in blepharitis may cause blockage and ultimately atrophy of the meibomian glands, worsening dry eye disease. Until recently, management of <i>Demodex</i> blepharitis has been limited by a lack of approved therapy options. Lotilaner ophthalmic solution 0.25%, the first approved therapy for treatment of <i>Demodex</i> blepharitis, has not only been shown to eradicate <i>Demodex</i> mites in one-half to two-thirds of patients following short-term treatment but also demonstrated continued benefits through 1 year of follow-up. In addition to managing <i>Demodex</i> blepharitis, treatment with lotilaner ophthalmic solution 0.25% may aid in the management of dry eye disease and other forms of ocular surface disease caused by complications of <i>Demodex</i> infestation. As a result, it is possible that successful management of <i>Demodex</i> blepharitis may reduce chronic use of health care resources dedicated to managing other chronic ocular conditions. As eye care professionals recognize <i>Demodex</i> infestation as a key mediator of ocular surface disease, increasing diagnostic awareness and addressing this underlying cause of <i>Demodex</i> blepharitis may reduce the need for specialist follow-up care, decrease the need for chronic therapy, and improve patient outcomes. Through routine screening for <i>Demodex</i> infestation and <i>Demodex</i> blepharitis, eye care professionals can now address an underlying factor in ocular surface disease to improve use of health care resources in the community.