Clinical Implications of Demodex Blepharitis

In this segment, Dr. Radhika Rampat discusses the significant clinical implications of demodex blepharitis and why targeted therapy is urgently needed. She explains that many patients repeatedly return with persistent symptoms—despite being treated with multiple nonspecific therapies. By adopting a more deliberate approach, including examining the eyelid margin for collarettes, she has observed strong correlations between high collarette counts and hallmark symptoms such as fluctuating vision, nocturnal eyelid itch, burning, and chronic dryness.

Dr. Rampat highlights why demodex blepharitis is highly relevant to surgeons. The condition can compromise refractive and cataract surgery by reducing scan accuracy, increasing the risk of postoperative “refractive surprise,” and elevating infection risk because eyelid flora often match pathogens found in surgical infections. She concludes that demodex blepharitis imposes a substantial burden on the NHS and global eye care systems, and that effective demodex-targeted therapy could transform clinical efficiency and patient outcomes.