Hom Milton M, Mastrota Katherine M, Schachter Scott E
Omni Eye Surgery, New York, NY, USA.
Optom Vis Sci. 2013 Jul;90(7):e198-205. doi: 10.1097/OPX.0b013e3182968c77.
Demodex folliculorum and Demodex brevis are ectoparasites with an astounding prevalence of 100% in patients aged 70 years and older. Every person in this age group is estimated to carry a colony of 1000 to 2000 mites. With such a high prevalence, little attention has been paid to the mite among eye care practitioners. We demonstrate a clinical sequence in a set of case reports to identify the mite. The clinical sequence includes a clinical history of blepharitis, dry eyes, and/or ocular allergy; slit lamp examination of cylindrical dandruff; and confirmation using light microscope evaluation of epilated lashes.
Patient 1 was a 68-year-old woman who demonstrates associations with dry eyes and diabetes. Patient 2 was a 44-year-old man with uncommonly seen D. brevis present. Patient 3 was a 40-year-old woman with dry eyes and allergy, showing mite tails protruding from base of lashes. Patient 4 was a 60-year-old woman who demonstrates the association with rosacea. Patient 5 was a 53-year-old woman intermittently taking topical steroid and antibiotic combination medications, with an actual mite photographed on the surface.
Following a clinical sequence helps identify Demodex, the underdiagnosed, undertreated, and underappreciated ocular surface disease.
毛囊蠕形螨和皮脂蠕形螨是外寄生虫，在70岁及以上患者中的患病率高达100%，令人震惊。据估计，这个年龄组的每个人都携带1000至2000只螨虫的群落。由于患病率如此之高，眼科护理从业者对螨虫的关注却很少。我们在一组病例报告中展示了一个识别螨虫的临床流程。该临床流程包括睑缘炎、干眼症和/或眼部过敏的临床病史；圆柱状头屑的裂隙灯检查；以及使用拔除睫毛的光学显微镜评估进行确认。
患者1是一名68岁女性，患有干眼症和糖尿病。患者2是一名44岁男性，罕见地出现了皮脂蠕形螨。患者3是一名40岁女性，患有干眼症和过敏，可见螨虫尾巴从睫毛根部突出。患者4是一名60岁女性，患有酒渣鼻。患者5是一名53岁女性，间歇性使用局部类固醇和抗生素联合药物，在其表面拍摄到了实际的螨虫。
遵循临床流程有助于识别蠕形螨，这是一种诊断不足、治疗不足且未得到充分重视的眼表疾病。
