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Might you have mites?

Mites?  On my eyes?  You got to be kidding me?!  Aren’t those little bugs like chiggers or lice?  Well…….yes.   They are technically a parasite that we all have on our skin.   I know, it sounds gross.  Perfect with Halloween coming up don’t you think?  Scary, little monsters eating our dead skin cells and living in our hair follicles or oil glands.   Probably itching already aren’t you?

There are two types of mites that tend to affect humans and especially around the eyes.  One is Demodex folliculorum that burrows into the eyelash or eyebrow hair follicles.  The other is Demodex brevis, which is a smaller version that often burrows into the sebaceous glands along the eyelid margin.   They are about 300 microns in length, which is about 3X the width of human hair so you are not going to see them crawling around without a microscope.   When Demodex mites infest a dog, you know it as “mange.”


We all carry the little bugs on our skin as do animals but when they get out of control is when they cause problems.  With the eye, it can cause a type of blepharitis or inflammation of the eyelid margins.  Often the lids are  red, irritated, dry, sometimes there is greasy debris along the base of the lashes as well as oil glands plugged up as well.  Bacterial or seborrheic blepharitis are more often to cause this but when it is difficult to get rid of with normal treatment, Demodex may be the underlying cause.   

To detect Demodex, your eye doctor examines the eyelash margin for characteristic greasy-looking “sleeves” around the bash of the lash.  This is the parasite’s body with the head remaining in the hair follicle. They can be seen by epilating (plucking) an eyelash which they are attached to and observed under high magnification with the microscope.

Treatment for Demodex normally consists of daily, eyelid cleansing with commercial eyelid cleaner such as Ocusoft Plus EyeLid Scrub, diluted tea tree oil and possibly antibacterial/steroid combination ointments to smother the mites and reduce inflammation, tea tree oil shampoo and face wash, thoroughly washing sheets and discarding pillows and treating pets that live in the house.   As we learn more about them, new treatments are being proposed such as Ivermectin.    Ivermectin has been used successfully in veterinary medicine in demodicosis of cats and dogs.  It is currently used off label in demodicosis of humans immuno-competent or infected by HIV.   There is growing evidence that acne rosacea of the face is related to immune reactions to Demodex too.

Demodex is as prevalent as dust mites,  which also can cause humans problems.  It’s just when they become overpopulated through poor hygiene or if your immune system weakens from age, disease or age that they can become problematic.

So if you are waking up with irritated, dry, red eyes, make sure your doctor has considered Demodex as the underlying cause.  It “mite” have been overlooked.

Courtesy of Dumas Vision Source, PLLC and Dr Tory W. Moore, Optometric Glaucoma Specialist and Diplomate of the American Board of Optometry.    Serving the Dumas, Texas,  Moore County and upper Texas Panhandle area for 23 years.   Call (806) 935-2020 for appointment or visit our optical gallery without an appointment.  Visit our website for more information.  Like our Facebook business page:  Dumas Vision Source  and you can also connect on Twitter @eyedocdumas

Tory Moore, OD  – “A Hometown Eye Doctor You Know and Can Trust!”