DDx
Diagnostic Considerations
Diagnositic considerations include the following:
Rosacea
Meibomian gland dysfunction
Phthiriasis (pubic lice) of the lids
Cyanoacrylate-glued false eyelashes



Differential Diagnoses
Media Gallery
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Illustration of Demodex folliculorum. Reprinted with permission from Antoine Morin, BIODIDAC, University of Ottawa.
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Eyelid section shows Demodex folliculorum (M) in the hair follicle. Note mite mouthparts (arrow) embedded in epithelium and straplike layers of keratin (hematoxylin and eosin, X400). Reprinted with permission from Elsevier Science.
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Section of sebaceous gland of an eyelash shows Demodex brevis (M). Note gland cell (C) destruction (McManus, X375). Reprinted with permission from Elsevier Science.
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Cross-section through small hair follicle of the eyelid. Note distension, hyperplasia, and moderate epithelial keratinization caused by the activities of Demodex folliculorum (arrow) (hematoxylin and eosin, X375). Reprinted with permission from Elsevier Science.
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Section of eyelid shows eyelash (L), cuffing (C), and small segment of Demodex folliculorum (M). Note layering of cuff (Masson, X275). Reprinted with permission from Elsevier Science.
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Demodex folliculorum.
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Demodex along the shaft of the cilia.
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Demodex along the shaft of the cilia (higher magnification).
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Backsides of numerous pubic crabs with infestation of the lashes and secondary blepharitis. Reprinted with permission from HD Riley, OD, Indiana University School of Optometry.
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Phthiriasis (Phthirus pubis) pubic crab lash infestation and secondary blepharitis. Reprinted with permission from HD Riley, OD, Indiana University School of Optometry.
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Phthiriasis (pubic lice). Reprinted with permission from HD Riley, OD, Indiana University School of Optometry.
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Demodex infestation is an under diagnosed cause of chronic blepharitis. Image courtesy of Rendia, Inc. Copyright 2017 Rendia, Inc.
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Blepharitis secondary to Demodex infestation. Image courtesy of Rendia, Inc. Copyright 2017 Rendia, Inc.
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A novel in-office treatment using a mechanical rotating handpiece with a microsponge tip combined with PolyaminopropylBiguanide foam solution removes oil, scurf, and debris; exfoliates the eyelids, and claims to decrease Demodex infestation. Image courtesy of Rendia, Inc. Copyright 2017 Rendia, Inc.
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Intense pulsed light. Courtesy of OPTIMED (https://www.optimed.co.uk/), E-referral and patient engagement platform.
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