Lash manipulation may be a better technique than complete epilation for detecting Demodex blepharitis, Irish researchers claim.

The Dublin-based investigators enrolled 107 subjects (428 eyelashes) and used a slit lamp biomicroscope to compare the quantity of Demodex folliculorum found first on a lash through manipulation and then on the same eyelash after epilation. Researchers rotated individual eyelashes from each lid with sterile forceps in situ and counted the number of mites that emerged from the follicle. They then removed the same eyelash and noted the number found. The study analyzed the data to check for agreement between the two techniques.

While both techniques identified generally similar amounts of mites, the study found consistently higher quantities of Demodex folliculorum through the lash manipulation technique. The overall mean quantity of mites was also greater on eyelash manipulation (1.45 mites; range, 0 to 13) compared with the microscopic examination of the epilated eyelashes (0.81 mites; range, 0 to 16), the study noted.

Also, the researchers reported weak levels of agreement between the two methods for addressing severity of infestation.

Eyelash epilation alone often results in miscounting because many Demodex remain within the follicle after the eyelash has been removed, the study reported.

“Using eyelash manipulation without epilation is much more comfortable for the patient, and in the current study, this method was found to be more accurate than epilation and microscopic examination for measuring quantity and assessing severity of infestation,” the researchers said in their paper. 

Murphy O, O’Dwyer V, Lloyd-McKernan A. The clinical use of eyelash manipulation in the diagnosis of demodex folliculorum blepharitis. Eye Contact Lens. April 2, 2019. [Epub ahead of print].