Should ocular Demodex be checked and treated in refractory keratitis patients without blepharitis?

AIM:To evaluate the correlation between Demodex infestation and keratitis,and to assess demodicosis using a simple approach.METHODS:A modified slit lamp illumination(at 40×magnification)was used to observe Demodex tails in 40patients with refractory keratitis and 80 healthy controls.Bacterial smear and culture of the conjunctival sac and corneal lesion were performed to identify the pathogen.Tea tree oil ointment(TTOO)was added as a Demodex killing agent for lid scrubs to the treatment when Demodex infestation was confirmed.RESULTS:Demodex tails were found in all patients compared to 42/80 of the controls(P<0.01).Seventeen patients presented blepharitis,while 23 were free of scales and inflammation at the lid margin.The demodicosis was mild,moderate,and severe in 8,19,and 13 patients,respectively,compared to mild in 42 controls(P<0.01).The keratitis was mild,moderate,and severe in 13,19,and 8patients,respectively.The severity of Demodex infestation was not correlated to the severity of keratitis(P=0.126).The growth of Staphylococcus was revealed in nine patients who did not react to antibiotic eye drops prior to the TTOO treatment.Patients’signs and symptoms got resolved after the lid scrub with TTOO.CONCLUSION:Ocular Demodex needs to be checked and treated in refractory keratitis patients with or without blepharitis.A slit-lamp illumination under high magnification favors the judgment of the severity of Demodex infestation.

Comparison of therapeutic effects of topical azithromycin solution and systemic doxycycline on posterior blepharitis

AIM:To compare the effect of azithromycin drop and doxycyciine capsule on treatment of posterior blepharitis.METHODS:Fifty patients(100 eyes) with moderate posterior blepharitis,randomly divided into two therapeutic groups;all the patients got warm eyelid compress and massage three times a day for 3wk.In addition the first group got azithromycin 1% drop,twice daily for 1wk and then one drop daily for 2wk.The second group got oral doxycyciine 100 mg daily for 3wk.At the end of the research,patients' signs and symptoms were compared together.ANOVA,Chi-square and MannWhitney tests were used for statistical analysis.RESULTS:Topical therapy with azithromycin and oral therapy with doxycyciine relieved signs and symptoms after 3wk.There were no significant differences between symptoms healing rate and foreign body sensation healing in these two groups(P>0.05).However,azithromycin drop was more effective in reduction of eye redness and doxycyciine was more effective in meibomian glands plugging healing and reducing the corneal staining.CONCLUSION:Topical azithromycin could have similar effects as oral doxycyciine on posterior blepharitis in improving subjective symptoms.However,doxycyciine can reduce objective signs such as ocular surface staining and meibomian gland plugging more than azithromycin.

A peculiar case of eye pruritus: Phthiriasis palpebrarum initially misdiagnosed as common blepharitis

Dear Sir, I am Dr. Jin Jiang, from the Department of Ophthalmology, Zhejiang Provincial People’s Hospital, Hangzhou, China. I write to present a peculiar case report of Phthiriasis palpebrarum initially misdiagnosed as common blepharitis. Phthirus pubis (crab louse) infests mainly the hair of the pubic and inguinal regions,

Coagulase-negative Staphylococci in Conjunctivitis and Blepharitis

Coagulase-negative staphylococcus (C-NS) are regarded asnormal flora of the lids and conjunctiva.The ability of these organisms tocause conjunctivitis and blepharitis can be overlooked or disregarded.Toelucidate the role of individual C-NS species in these eye diseases wecompared Staphylococcus sp.isolated from the conjunctiva and lids of 50healthy volunteers with 248 strains of Staphylococcus isolated frompatients with staphylococcal conjunctivitis or blepharitis.S.epidermidiswas the most frequent spec...