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Occurrence of Demodex species in patients with blepharitis and in healthy individuals: a 10-year observational study



Two Demodex species (eyelash mites)—D. folliculorum and D brevis—are believed to be associated with human skin and eye diseases. However, the clinical significance of infection with Demodex species remains controversial.

Study design

The aim of this study was to estimate the prevalence of ocular demodicosis in patients with blepharitis as compared with the prevalence in the healthy population in Poland.


This case-control prospective study was carried out from 2007 to 2016. The enrolled patients (668) were divided into 2 groups: the study group, comprising 553 patients with blepharitis (349 women and 204 men, aged 17–88 years), and the control group, comprising 115 healthy volunteers without a history of ocular pathologies (78 women and 37 men, aged 17–88 years). A sample of 10 eyelashes was taken aseptically from each eye of the examined person and later studied under a light microscope.


Demodex species were found in 62.4% (345/544) of the patients in the study group and in 24.3% (28/100) of the controls (P = .001, OR = 0.006). The overall prevalence was 55.8% (373/668) in all the examined participants. The presence of Demodex infection increased with age in both groups. No association of Demodex infection with gender was found (119/204 vs 226/349; P > .05, OR 1.086). A high mean number of mites was present more frequently in patients aged older than 50 years and in those who complained especially about itching (P < .05).


The prevalence of ocular demodicosis is significantly correlated with blepharitis and increases with age.

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  1. Cheng AM, Sheha H, Tseng SC. Recent advances on ocular Demodex infestation. Curr Opin Ophthalmol. 2015;26:295–300.

    Article  Google Scholar 

  2. Marcinowska Z, Kosik-Bogacka D, Łanocha-Arendarczyk N, Czepita D, Łanocha A. Demodex folliculorum and Demodex brevis. Pom J Life Sci. 2015;61:108–14.

    Article  Google Scholar 

  3. Herron MD, O’Reilly MA, Vanderhooft SL. Refractory Demodex folliculitis in five children with acute lymphoblastic leukemia. Pediatr Dermatol. 2005;22:407–11.

    Article  Google Scholar 

  4. Kaya S, Selimoglu MA, Kaya OA, Ozgen U. Prevalence of Demodex folliculorum and Demodex brevis in childhood malnutrition and malignancy. Pediatr Int. 2013;55:85–9.

    Article  Google Scholar 

  5. Liang L, Safran S, Gao Y, Sheha H, Raju VK, Tseng SCG. Ocular demodicosis as a potential cause of pediatric blepharoconjunctivitis. Cornea. 2010;29:1386–91.

    Article  Google Scholar 

  6. Liu J, Sheha H, Tseng SCG. Pathogenic role of Demodex mites in blepharitis. Curr Opin Allergy Clin Immunol. 2010;10:505–10.

    Article  Google Scholar 

  7. Kim JT, Lee SH, Chun YS, Kim JC. Tear cytokines and chemokines in patients with Demodex blepharitis. Cytokine. 2011;53:94–9.

    CAS  Article  Google Scholar 

  8. Lacey N, Raghallaigh SN, Powell FC. Demodex mites: commensals, parasites or mutualistic organism? Dermatology. 2011;11:1–3.

    Google Scholar 

  9. Nicholls SG, Oakley CL, Tan A, Vote B. Demodex species in human ocular disease: new clinicopathological aspects. Int Ophthalmol. 2017;37:303–12.

    Article  Google Scholar 

  10. Kemal M, Sűmer Z, Toker MI, Erdogan H, Topalkara A, Akbulut M. The prevalence of Demodex folliculorum in blepharitis patients and the normal population. Ophthalmic Epidemiol. 2005;12:287–90.

    Article  Google Scholar 

  11. Wesołowska M, Knysz B, Reich A, Blazejewska D, Czarnecki M, Gładysz A, et al. Prevalence of Demodex spp. in eyelash follicles in different populations. Arch Med Sci. 2014;10:319–24.

    Article  Google Scholar 

  12. Horvath A, Neubrandt DM, Ghidan A, Nagy K. Risk factors and prevalence of Demodex mites in young adults. Acta Microbiol Immunol Hung. 2011;58:145–55.

    Article  Google Scholar 

  13. Garbacewicz A, Udziela M, Grytner-Zięcina B, Szaflik JP, Szaflik J. Demodex infections in general Polish population, in patients suffering from blepharitis, and among people who work with microscopes. Klin Oczna. 2010;112:307–10.

    PubMed  Google Scholar 

  14. Kabataş N, Doğan AŞ, Kabataş EU, Acar M, Biçer T, Gürdal C. The effect of Demodex infestation on blepharitis and the ocular symptoms. Eye Contact Lens. 2017;43:64–7.

    Article  Google Scholar 

  15. Helou W, Avitan-Hersh E, Bergman R. Demodex folliculitis of the scalp: clinicopathological study of an uncommon entity. Am J Dermatopathol. 2016;38:658–63.

    Article  Google Scholar 

  16. Sędzikowska A, Osęka M, Grytner-Zięcina B. Ocular symptoms reported by patients infested with Demodex mites. Acta Parasitol. 2016;61:808–14.

    Article  Google Scholar 

  17. Abokwidir M, Fleischer AB Jr. Additional evidence that rosacea pathogenesis may involve demodex: new information from the topical efficacy of ivermectin and praziquantel. Dermatol Online J. 2015;21:pii:13030/qt13v249f5.

  18. Arasiewicz H, Szilman P, Brzezińska-Wcisło L. Demodex folliculorum in rosacea based on a modified standardized skin surface biopsy. Post Nauk Med. 2015;5:177–80.

    Article  Google Scholar 

  19. Anane S, Mokni M, Beltaief O. Rosacea-like demodicosis and chronic blepharitis. Ann Dermatol Venerol. 2011;138:30–4.

    CAS  Article  Google Scholar 

  20. Gao YY, Di Pascuale MA, Li W, Liu DT, Baradaran-Rafii A, Elizonado A, et al. High prevalence of Demodex in eyelashes with cylindrical dandruff. Invest Ophthalmol Vis Sci. 2005;46:3089–94.

    Article  Google Scholar 

  21. Rather PA, Hassan I. Human Demodex mite: the versatile mite of dermatological importance. Indian J Dermatol. 2014;59:60–6.

    Article  Google Scholar 

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We thank Richard Ashcroft for correction of the manuscript.

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Correspondence to Monika Maria Biernat.

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M. M. Biernat, None; J. R. -Ziółkowska, None; E. Piątkowska, None; I. Helemejko, None; P. Biernat, None; G. Gościniak, None.

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Corresponding author: Monika Maria Biernat

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Biernat, M.M., Rusiecka-Ziółkowska, J., Piątkowska, E. et al. Occurrence of Demodex species in patients with blepharitis and in healthy individuals: a 10-year observational study. Jpn J Ophthalmol 62, 628–633 (2018).

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  • Blepharitis
  • Demodex
  • Ocular demodicosis