Could ocular demodicosis be a risk factor for punctal stenosis, dry eye, and blepharitis?

Abstract

Purpose: Demodex, an ectoparasite, can threaten eye health by settling into different eyelash bases. It is particularly suggested to cause dysfunction in the Meibomian glands. This cross-sectional study aimed to investigate the relationships between ocular demodicosis, punctal stenosis, dry eye, and blepharitis.

Methods: A total of 144 patients who presented to the Ophthalmology Clinic and volunteered to participate in the study were included. The demographic characteristics of the patients, presence of blepharitis, tear breakup time, eye-watering according to Munk's epiphora scoring, and punctal structures according to Kashkouli classification were recorded. Eyelash epilation was performed while preserving the root structure, and the eyelashes were examined under a light microscope. The relationship between Demodex presence and severity with punctal structure, dry eye status, and blepharitis was evaluated.

Results: No significant relationship was found between punctal stenosis and Demodexspp. infestation in both eyes (P > 0.05). Overall, there was a statistical relationship between the presence of Demodexspp. settled in the eyelashes (right lower and upper, left upper eyelid lashes) and dry eye (P < 0.05), but there was no relationship with Demodex density (>3/eyelid). In eyes with blepharitis, especially in patients with anterior blepharitis, the presence and density of Demodexspp. were higher than in patients without blepharitis (P < 0.001 for the right upper, left lower, and upper eyelids, P = 0.001 for the right lower eyelid).

Conclusion: Demodex infestations may be associated with blepharitis and dryness of eyes, but there is no association with punctal stenosis.