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• W4234434786 abstract "We thank Raju et al for their comments concerning our paper “Associated Morbidity of Blepharitis.” We agree with them that Demodex is also a possible association with blepharitis. The ectopic parasite Demodex is the most common parasite in humans. It inhabits the eyelids, cilia, meibomian glands, face, and external otic tract. In the eyelids it lives deep in the meibomian glands and the sebaceous glands of the lash, and eat skin cells, hormones, and oils that accumulate within the hair follicle.1Karincaoglu Y. Bayram N. Aycan O. et al.The clinical importance of Demodex folliculorum presenting with nonspecific facial signs and symptoms.J Dermatol. 2004; 31: 618-626Crossref PubMed Scopus (78) Google Scholar Demodex has been considered an etiological factor of chronic blepharitis, meibomian gland dysfunction, and ocular surface inflammation.2Gao Y.Y. Di Pascuale M.A. Elizondo A. et al.Clinical treatment of ocular demodecosis by lid scrub with tea tree oil.Cornea. 2007; 26: 136-143Crossref PubMed Scopus (148) Google Scholar Recently, Lee et al have shown a strong correlation between the number of Demodex and the severity of subjective symptoms of the ocular surface, suggesting that Demodex plays a pathogenic role in the ocular discomfort linked with aging.3Lee S.H. Chun Y.S. Kim J.H. et al.The relationship between demodex and ocular discomfort.Invest Ophthalmol Vis Sci. 2010; 51: 2906-2911Crossref PubMed Scopus (100) Google Scholar However, Demodex can be found in asymptomatic individuals, and its pathogenic role has long been debated. Some studies have advocated that Demodex is a nonpathogenic parasite and demodicosis is found in persons who are immune-suppressed.4Kemal M. Sümer Z. Toker M.I. et al.The prevalence of demodex folliculorum in blepharitis patients and the normal population.Ophthalmic Epidemiol. 2005; 12: 287-290Crossref PubMed Scopus (101) Google Scholar Because it is a host-specific obligate parasite that cannot be grown in vitro, Demodex is very difficult to study and inducing an experimental infestation is difficult.3Lee S.H. Chun Y.S. Kim J.H. et al.The relationship between demodex and ocular discomfort.Invest Ophthalmol Vis Sci. 2010; 51: 2906-2911Crossref PubMed Scopus (100) Google Scholar Daily lid scrub with tea tree oil shampoo is effective in eradicating ocular Demodex. Recently, oral ivermectin has been reported to be an efficient, practical, and safe alternative treatment for recalcitrant chronic blepharitis associated with Demodex.5Filho P.A. Hazarbassanov R.M. Grisolia A.B. et al.The efficacy of oral ivermectin for the treatment of chronic blepharitis in patients tested positive for Demodex spp.Br J Ophthalmol. 2011; 95: 893-895Crossref PubMed Scopus (43) Google Scholar In our article, we evaluated the systemic associations of blepharitis. Information regarding Demodex infestation was not present in the database of the health maintenance organization we studied. However, we do believe that Demodex is a possible etiology for blepharitis. Demodex BlepharitisOphthalmologyVol. 119Issue 1PreviewWe read with interest the article by Nemet et al.1 Full-Text PDF" @default.
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• W4234434786 doi "https://doi.org/10.1016/j.ophtha.2011.10.012" @default.
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