Diagnosing Demodex blepharitis with the slit lamp

Transcript

0:05 – My name is Filomena Ribeiro. I’m from Portugal, Lisbon.
0:09 – I’m head of the Department of Ophthalmology of Hospital da Luz in Lisbon.
0:15 – I also teach in the University of Lisbon and the Catholic University, and I’m the current President of ESCRS.
0:25 – Although the disease is under-diagnosed, but the truth is it’s very easy to do the diagnosis in the first approach of our patient in the slit lamp.
0:37 – So if you are at the slit lamp, you just need to ask your patient to close a little bit the eyes and you will see this pathognomonic sign of Demodex blepharitis.
0:53 – So when we reach out to the eyelash of patients with this disease, it’s amazing what sometimes we can miss if we are not looking for the collarettes that we can see in our patients and it’s something that we need to train the clinicians to be aware of these sign of the disease.
1:21 – My name is Mayank Nanavaty, and I work as a consultant ophthalmic surgeon at Brighton, which is in the United Kingdom.
1:28 – In my experience, you will see more collarettes on the upper lid lashes than the lower lid lashes.
1:33 – And the shape and size of these collarettes may vary from patient to patient and coexisting pathologies as well.
1:41 – Some patients may have smaller ones, subtle ones and some patients may have very classic ones and very prominent ones.
1:47 – It does take a while to get used to looking for these collarettes in most of the patients we routinely see because oftentimes we are sent patients for different diagnosis not just for the Demodex blepharitis.
1:58 – And in passing you may find out the patient has got irritation and history of itching the lids.
2:06 – And in those patients especially, I would urge all my colleagues to look for the collarettes in these patients.
2:13 – But also now it’s become a habit for me to look at these collarettes in most of my patients who are coming on the slit lamp for any reason.
2:21 – My name is Erik Mertens, I’m a vision correction surgeon and I’m based in Antwerp, Belgium.
2:27 – When I diagnose Demodex blepharitis, I try to explain to my patients that there are mites, the Demodex mites there, but it’s the same as the dust mites.
2:38 – Since a lot of patients in my country are allergic to dust mites.
2:43 – They know they’re very tiny creatures living in your houses and on your clothes and so on.
2:49 – So I tell them that’s it’s the same type of creature, it’s very small and it’s living with us and it causes, like a dust mite, causes some allergies, like sneezing or itching.
3:05 – This mite, the Demodex, can also cause some redness on your eyelids and itchiness.
3:11 – But when you draw a parallel between the dust mite and the Demodex mite, they understand that it is that’s a very small thing living on our skin and in our eyelashes.
3:24 – And by explaining this this way, they’re not freaking out by this diagnosis.