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The aim of this systematic review was to summarise and synthesise current clinical evidence relating to the aetiology, diagnosis and treatment of ocular\n                      <jats:italic>Demodex<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Recent findings<\/jats:title>\n                    <jats:p>\n                      A comprehensive literature search was performed in OVID Medline, OVID Embase, and clinical trial registries, for studies published between 1990 and August 2019, examining\n                      <jats:italic>Demodex<\/jats:italic>\n                      on the ocular surface. The review included primary clinical research studies and systematic reviews of primary clinical research studies, where\n                      <jats:italic>Demodex<\/jats:italic>\n                      was considered in the context of the ocular surface and\/or adnexa. Studies were categorised using the National Health and Medical Research Council evidence hierarchy. Risk of bias assessment was performed using validated tools for studies categorised as providing Level I or II evidence.\n                    <\/jats:p>\n                    <jats:p>\n                      A total of 87 studies were eligible for inclusion, including two systematic reviews. Most studies (60%) were observational, describing the prevalence of ocular\n                      <jats:italic>Demodex<\/jats:italic>\n                      in different clinical populations. There was a high degree of variability in the epidemiological data derived from cross\u2010sectional aetiology studies. There was mostly consistent evidence to support an association between ocular\n                      <jats:italic>Demodex<\/jats:italic>\n                      and chronic blepharitis. Seven diagnostic test\u2010accuracy studies were identified, which considered a range of techniques, including slit lamp examination for cylindrical eyelash collarettes and\/or eyelash manipulation techniques, light microscopic evaluation of epilated eyelashes and\n                      <jats:italic>in vivo<\/jats:italic>\n                      confocal microscopy. There is currently no accepted gold\u2010standard diagnostic method for ocular\n                      <jats:italic>Demodex.<\/jats:italic>\n                      For intervention studies, there was one systematic review, 11 published randomised trials, six trial registry entries, and nine case series. Despite a number of recent trials, the appropriate treatment regimen for ocular\n                      <jats:italic>Demodex<\/jats:italic>\n                      (including the optimal criteria and timing of an intervention) is not clearly established.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This comprehensive narrative synthesis has captured the landscape of clinical evidence relating to the prevalence, aetiology, diagnosis and treatment of ocular\n                      <jats:italic>Demodex<\/jats:italic>\n                      . There remain opportunities to enhance understanding of its role in ocular surface disease, best diagnostic approaches and optimal treatment protocols.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/opo.12691","type":"journal-article","created":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T05:04:35Z","timestamp":1595307875000},"page":"389-432","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":72,"title":["Ocular\n                    <i>Demodex<\/i>\n                    : a systematic review of the clinical literature"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1101-2870","authenticated-orcid":false,"given":"Alexis Ceecee","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Optometry and Vision Sciences The University of Melbourne Melbourne 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