Intended for healthcare professionals

Practice 10-Minute Consultation


BMJ 2012; 344 doi: (Published 23 May 2012) Cite this as: BMJ 2012;344:e3328

Re: Blepharitis

We agree with T Graham Edwards(1) that Demodex folliculorumis a commensal found in normal people as well. According to Galvis-Ramírez V(2) it is a parasite found in people without ocular lesions as well, but, it is more frequent and has a higher parasite burden in patients with blepharitis2. Their results, thus, suggested the need for investigating the presence of D. folliculorum in all patients suffering from blepharitis, especially in cases where cylinder-type scaling has been observed in their eyelashes2. According to a recent Cochrane review the exact etiopathogenesis is unknown, but suspected to be multifactorial, including chronic low-grade infections of the ocular surface with bacteria, infestations with parasites such as demodex, and inflammatory skin conditions such as atopy and seborrhea3. Though the current article gives the treatment, but according to Cochrane Review, “Despite identifying 34 trials related to treatments for blepharitis, there is no strong evidence for any of the treatments in terms of curing chronic blepharitis3. Commercial products are marketed to consumers and prescribed to patients without substantial evidence of effectiveness3. Further research is needed to evaluate the effectiveness of such treatments”3.


2. Galvis-Ramírez V, Tello-Hernández A, Álvarez-Osorio L, Rey-Serrano JJ. [The prevalence of Demodex folliculorum infection in patients attending a general ophthalmological consultation]. Rev Salud Publica (Bogota). 2011 Dec;13(6):990-7. [Article in Spanish]
3. Lindsley K, Matsumura S, Hatef E, Akpek EK.Interventions for chronic blepharitis. Cochrane Database Syst Rev. 2012 May 16;5:CD005556.
4. Turnbull AM, Mayfield MP. Blepharitis. BMJ. 2012 May 23;344:e3328. doi: 10.1136/bmj.e3328.

Competing interests: No competing interests

21 October 2012
Neeru Gupta
Scientist E
Indian Council of Medical Reserch
Ansari Nagar, New Delhi-110029