Alver et al reported a clinical score for the extent of ocular involvement in a patient infected with Demodex. This can help guide therapy over time. The authors are from Uludag University in Bursa, Turkey.
Patient selection: possible Demodex folliculorum
Parameters:
(1) symptoms
(2) anterior blepharitis
(3) posterior blepharitis
(4) cylindrical dandruff on eyelashes
(5) chronic use of an eye drop that contains a preservative (including glaucoma)
(6) any cause of dry eye other than blepharitis
(7) epithelial defect on cornea
(8) keratitis (secondary to Meibomitis/posterior blepharitis)
|
Parameter
|
Finding
|
Points
|
|
symptoms
|
any of burning, stinging, itching and/or pain
|
1
|
|
|
none of these
|
0
|
|
anterior blepharitis
|
no
|
0
|
|
|
yes
|
1
|
|
posterior blepharitis
|
no
|
0
|
|
|
yes
|
1
|
|
cylindrical dandruff
|
no
|
0
|
|
|
yes
|
2
|
|
chronic use of eye drops
|
no
|
0
|
|
|
yes
|
1
|
|
dry eye
|
no
|
0
|
|
|
yes
|
2
|
|
epithelial defect cornea
|
no
|
0
|
|
|
yes
|
1
|
|
keratitis
|
no
|
0
|
|
|
yes
|
2
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 11
• The higher the score the more likely Demodex infection and the more severe the ocular involvement.
• A score >= 3 is seen in 72% of patients with Demodex infection.
• Cylindrical dandruff is pathognomonic for Demodex infection.
