{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T17:54:49Z","timestamp":1782928489273,"version":"3.54.5"},"reference-count":14,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T00:00:00Z","timestamp":1749945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Herein, we present scanning electron microscopy imagery of Demodex folliculorum on the eyelashes of a patient with a two-year history of dry, burning, and watery eyes. Demodex mites are part of the normal human skin flora, inhabiting hair follicles and sebaceous glands. However, in some individuals, they may contribute to ocular surface diseases, including blepharitis and dry eye disease. Symptoms often include itching, photophobia, and a foreign body sensation. The pathogenic role of Demodex is not fully understood but may involve microabrasions, gland obstruction, hypersensitivity reactions, and bacterial dysbiosis. The presence of collarettes at the base of eyelashes is a diagnostic hallmark. Although optimal treatment remains debated, options include topical tea tree oil, ivermectin, and a recently FDA-approved drug lotilaner. Our patient responded favorably to a two-month regimen of tea tree oil-based eyelid wipes. This case underscores the clinical relevance of Demodex infestation in chronic ocular discomfort and highlights the importance of diagnostics.<\/jats:p>","DOI":"10.3390\/diagnostics15121520","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T04:06:24Z","timestamp":1750046784000},"page":"1520","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Demodex folliculorum\u00a0"],"prefix":"10.3390","volume":"15","author":[{"given":"Ayyad Zartasht","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, \u00d8stfold Hospital Trust, 1524 Moss, Norway"},{"name":"Department of Ophthalmology, S\u00f8rlandet Hospital Trust, 4838 Arendal, Norway"},{"name":"Department of Medical Biochemistry, Oslo University Hospital, 0372 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3835-8772","authenticated-orcid":false,"given":"Fredrik","family":"Fineide","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Oslo University Hospital, 0372 Oslo, Norway"},{"name":"The Norwegian Dry Eye Clinic, 0368 Oslo, Norway"},{"name":"Department of Plastic and Reconstructive Surgery, Oslo University Hospital, 0372 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7726-1557","authenticated-orcid":false,"given":"Jens","family":"Wohlmann","sequence":"additional","affiliation":[{"name":"Electron Microscopy Laboratory, Department of Biosciences, University of Oslo, 0316 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjell Gunnar","family":"Gundersen","sequence":"additional","affiliation":[{"name":"Ifocus Eye Clinic, 5531 Haugesund, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2867-3336","authenticated-orcid":false,"given":"Morten","family":"Gundersen","sequence":"additional","affiliation":[{"name":"Ifocus Eye Clinic, 5531 Haugesund, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8697-0734","authenticated-orcid":false,"given":"Miriam","family":"Kolko","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet-Glostrup, 2600 Glostrup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tor Paaske","family":"Utheim","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, \u00d8stfold Hospital Trust, 1524 Moss, Norway"},{"name":"Department of Ophthalmology, S\u00f8rlandet Hospital Trust, 4838 Arendal, Norway"},{"name":"Department of Medical Biochemistry, Oslo University Hospital, 0372 Oslo, Norway"},{"name":"The Norwegian Dry Eye Clinic, 0368 Oslo, Norway"},{"name":"Department of Plastic and Reconstructive Surgery, Oslo University Hospital, 0372 Oslo, Norway"},{"name":"Department of Ophthalmology, Drammen Hospital, Vestre Viken Trust, 3004 Drammen, Norway"},{"name":"Department of Ophthalmology, Oslo University Hospital, 0372 Oslo, Norway"},{"name":"Department of Ophthalmology, Stavanger University Hospital, 4011 Stavanger, Norway"},{"name":"Department of Ophthalmology, Vestfold Hospital Trust, 3103 T\u00f8nsberg, Norway"},{"name":"Department of Clinical Medicine, Faculty of Medicine, University of Bergen, 5021 Bergen, Norway"},{"name":"Department of Research and Development, Oslo Metropolitan University, 0130 Oslo, Norway"},{"name":"National Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health Sciences, University of South-Eastern Norway, 3616 Kongsberg, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Thoemmes, M.S., Fergus, D.J., Urban, J., Trautwein, M., and Dunn, R.R. (2014). Ubiquity and diversity of human-associated Demodex mites. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0106265"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1017\/S003118200006858X","article-title":"Studies on Demodex folliculorum simon (1842). I. Life history","volume":"51","author":"Spickett","year":"1961","journal-title":"Parasitology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1097\/ICL.0000000000001003","article-title":"Demodex Blepharitis: A Comprehensive Review of the Disease, Current Management, and Emerging Therapies","volume":"49","author":"Rhee","year":"2023","journal-title":"Eye Contact Lens"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"43","DOI":"10.18282\/jsd.v1.i1.42","article-title":"Important aspects of Demodex diagnostics","volume":"1","author":"Kubanov","year":"2016","journal-title":"J. Surg. Dermatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1007\/s12639-013-0405-3","article-title":"Demodicosis caused by Demodex canis and Demodex cornei in dogs","volume":"39","author":"Sivajothi","year":"2015","journal-title":"J. Parasit. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.2147\/OPTH.S354692","article-title":"The Prevalence of Demodex Blepharitis in US Eye Care Clinic Patients as Determined by Collarettes: A Pathognomonic Sign","volume":"16","author":"Trattler","year":"2022","journal-title":"Clin. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1080\/02713683.2023.2265083","article-title":"The Use of Digital PCR for the Diagnosis of Demodex Blepharitis","volume":"49","author":"An","year":"2024","journal-title":"Curr. 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Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1080\/02713683.2018.1536217","article-title":"Therapeutic Effect of Intense Pulsed Light on Ocular Demodicosis","volume":"44","author":"Zhang","year":"2019","journal-title":"Curr. Eye Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1007\/s40265-023-01947-9","article-title":"Lotilaner Ophthalmic Solution 0.25%: First Approval","volume":"83","author":"Syed","year":"2023","journal-title":"Drugs"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1083\/jcb.90.1.222","article-title":"Structural interaction of cytoskeletal components","volume":"90","author":"Schliwa","year":"1981","journal-title":"J. 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Cell Sci."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/12\/1520\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:52:20Z","timestamp":1760032340000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/12\/1520"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,15]]},"references-count":14,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["diagnostics15121520"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15121520","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,15]]}}}