• Cornea/External Disease

    This prospective study of 59 consecutive patients with various ocular surface diseases found that Demodex infestation is strongly correlated with serum immunoreactivity to two B oleronius proteins and facial rosacea, only marginally correlated with lid margin inflammation and negatively correlated with aqueous tear-deficiency in dry eye. Neither serum immunoreactivity nor facial rosacea were associated with bulbar conjunctival inflammation. Serum immunoreactivity was strongly correlated with facial rosacea and lid margin inflammation.

    The study's results provide further evidence of the comorbidity between Demodex infestation and Bacillus infection in facial rosacea and greater understanding of the occurrence of ocular surface inflammation in some ocular Demodex-infested patients. If the correlation among serum immunoreactivity, ocular Demodex infestation, rosacea and blepharitis is found to be causative, the authors speculate regarding a pathogenic link between Demodex infestation and microbial infection by B oleronius in ocular surface inflammation. 

    The authors note that comorbidity based on a symbiotic relationship of B oleronius and Demodex mites justifies the consideration of treatment designed to kill the symbiotic bacterium via oral antibiotics, such as tetracycline, and kill and prevent mating of and reinfestation with Demodex mites via treatments, such as tea tree oil lid scrubs and general hygiene.