{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:28:08Z","timestamp":1786739288440,"version":"build-2736575974"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE:<\/jats:title>\n                    <jats:p>The purpose of this study is to present characteristics and topographic findings of patients with corneal ectasia and symptomatic ocular demodicosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS:<\/jats:title>\n                    <jats:p>\n                      A retrospective, noncomparative study. Twenty-one patients with symptomatic ocular demodicosis and corneal ectasia since 2017 to 2019 were enrolled. Patients with dry eye syndrome and meibomian gland dysfunction were identified and treated. Demographic data, topography, and clinical data were collected. All patients underwent lash sampling to confirm\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      mite infestation by direct visualization under the microscope.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Twenty-one ectasia patients (36 eyes) were enrolled with male preponderance (M:F =18:3). Mean age (years) was 28.6 \u00b1 8.12. Of the 21 cases reviewed, the average number of topography taken was 6.8 within 43.8 months of follow-up. Corneal ectasia was characterized by focal thinning area beside central cornea, with corresponding mean thickness of 487.1 \u03bcm and 518 \u03bcm, respectively. All ectasia patients were combined with\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      blepharitis and associated symptoms, proven by direct microscopic examination. After treatment with eyelid cleanser (OCuSOFT\u00ae Lid Scrub\u00ae PLUS), warm compress, and improved daily hygiene, ocular demodicosis and topographic changes were controlled and even reversed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>\n                      Our results indicated that ocular demodicosis may be potentially associated with corneal ectasia.\n                      <jats:italic toggle=\"yes\">Demodex<\/jats:italic>\n                      blepharitis still remains an overlooked differential diagnosis in clinic; however, it may be one of the risk factors triggering eye rubbing. Comorbidity of lid infestation with eye rubbing may lead to corneal ectasia, even in elder patients with thick cornea. Therefore, meticulous examination and intensive treatment were highly recommended in this group of patients.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/tjo.tjo_45_20","type":"journal-article","created":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T03:09:31Z","timestamp":1601435371000},"page":"146-155","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Clinical characteristics and topographic findings of corneal ectasia in patients with symptomatic Demodex blepharitis"],"prefix":"10.4103","volume":"11","author":[{"given":"Kuo-Hsuan","family":"Hung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin-Yuan","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Chi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lung-Kun","family":"Yeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-6-20240830","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S0039-6257(97)00119-7","article-title":"Keratoconus","volume":"42","author":"Rabinowitz","year":"1998","journal-title":"Surv Ophthalmol"},{"key":"R2-6-20240830","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1016\/j.jcrs.2013.08.061","article-title":"Comparative evaluation of dual Scheimpflug imaging parameters in keratoconus, early keratoconus, and normal eyes","volume":"40","author":"Reddy","year":"2014","journal-title":"J Cataract Refract Surg"},{"key":"R3-6-20240830","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1016\/j.jcrs.2013.03.023","article-title":"Posterior corneal elevation and back difference corneal elevation in diagnosing forme fruste keratoconus in the fellow eyes of unilateral keratoconus patients","volume":"39","author":"Muftuoglu","year":"2013","journal-title":"J Cataract Refract Surg"},{"key":"R4-6-20240830","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.clae.2016.10.001","article-title":"Systemic review comparing penetrating keratoplasty and deep anterior lamellar keratoplasty for management of keratoconus","volume":"40","author":"Henein","year":"2017","journal-title":"Cont Lens Anterior Eye"},{"key":"R5-6-20240830","doi-asserted-by":"crossref","first-page":"2434830","DOI":"10.1155\/2017\/2434830","article-title":"Risk assessment for corneal ectasia following photorefractive keratectomy","volume":"2017","author":"Sorkin","year":"2017","journal-title":"J Ophthalmol"},{"key":"R6-6-20240830","doi-asserted-by":"crossref","first-page":"713","DOI":"10.2147\/OPTH.S51313","article-title":"Ectasia risk factors in refractive surgery","volume":"10","author":"Santhiago","year":"2016","journal-title":"Clin Ophthalmol"},{"key":"R7-6-20240830","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1136\/bjo.84.8.834","article-title":"Atopy and keratoconus: A multivariate analysis","volume":"84","author":"Bawazeer","year":"2000","journal-title":"Br J Ophthalmol"},{"key":"R8-6-20240830","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1111\/j.1444-0938.2003.tb03082.x","article-title":"Keratoconus, allergy, itch, eye-rubbing and hand-dominance","volume":"86","author":"McMonnies","year":"2003","journal-title":"Clin Exp Optom"},{"key":"R9-6-20240830","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1111\/bjd.12850","article-title":"Human demodicosis: Revisit and a proposed classification","volume":"170","author":"Chen","year":"2014","journal-title":"Br J Dermatol"},{"key":"R10-6-20240830","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.ajo.2007.01.054","article-title":"Corneal manifestations of ocular demodex infestation","volume":"143","author":"Kheirkhah","year":"2007","journal-title":"Am J Ophthalmol"},{"key":"R11-6-20240830","doi-asserted-by":"crossref","first-page":"3089","DOI":"10.1167\/iovs.05-0275","article-title":"High prevalence of Demodex in eyelashes with cylindrical dandruff","volume":"46","author":"Gao","year":"2005","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"R12-6-20240830","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.jcrs.2014.04.013","article-title":"Biomechanics of corneal ectasia and biomechanical treatments","volume":"40","author":"Roberts","year":"2014","journal-title":"J Cataract Refract Surg"},{"key":"R13-6-20240830","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/ACI.0b013e32833df9f4","article-title":"Pathogenic role of Demodex mites in blepharitis","volume":"10","author":"Liu","year":"2010","journal-title":"Curr Opin Allergy Clin Immunol"},{"key":"R14-6-20240830","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/ICO.0b013e3181839b06","article-title":"Keratoconus in the Medicare population","volume":"28","author":"Reeves","year":"2009","journal-title":"Cornea"},{"key":"R15-6-20240830","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.optom.2015.05.001","article-title":"Effect of ageing on keratoconic corneas","volume":"9","author":"Millodot","year":"2016","journal-title":"J Optom"},{"key":"R16-6-20240830","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.clae.2007.03.001","article-title":"Collaborative longitudinal evaluation of keratoconus (CLEK) study: Methods and findings to date","volume":"30","author":"Wagner","year":"2007","journal-title":"Cont Lens Anterior Eye"},{"key":"R17-6-20240830","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1038\/eye.2000.154","article-title":"Does ethnic origin influence the incidence or severity of keratoconus?","volume":"14","author":"Pearson","year":"2000","journal-title":"Eye (Lond"},{"key":"R18-6-20240830","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.ajo.2009.06.024","article-title":"Prevalence and associations of keratoconus in rural maharashtra in central India: The central India eye and medical study","volume":"148","author":"Jonas","year":"2009","journal-title":"Am J Ophthalmol"},{"key":"R19-6-20240830","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1097\/ICO.0b013e3182a0d014","article-title":"Prevalence of keratoconus in a population-based study in Shahroud","volume":"32","author":"Hashemi","year":"2013","journal-title":"Cornea"},{"key":"R20-6-20240830","doi-asserted-by":"crossref","first-page":"137","DOI":"10.5021\/ad.2017.29.2.137","article-title":"Demodex mite density determinations by standardized skin surface biopsy and direct microscopic examination and their relations with clinical types and distribution patterns","volume":"29","author":"Yun","year":"2017","journal-title":"Ann Dermatol"},{"key":"R21-6-20240830","first-page":"1","article-title":"Clinical and epidemiological features of keratoconus genetic and external factors in the pathogenesis of the disease","volume":"178","author":"Ihalainen","year":"1986","journal-title":"Acta Ophthalmol Suppl"},{"key":"R22-6-20240830","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1038\/eye.1998.165","article-title":"Referral patterns, treatment management and visual outcome in keratoconus","volume":"12","author":"Weed","year":"1998","journal-title":"Eye (Lond"},{"key":"R23-6-20240830","doi-asserted-by":"crossref","first-page":"259","DOI":"10.3928\/1081597X-20100218-01","article-title":"Epithelial, stromal, and total corneal thickness in keratoconus: Three-dimensional display with Artemis very-high frequency digital ultrasound","volume":"26","author":"Reinstein","year":"2010","journal-title":"J Refract Surg"},{"key":"R24-6-20240830","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1016\/j.jcrs.2014.08.035","article-title":"Evaluation of scleral and corneal thickness in keratoconus patients","volume":"41","author":"Schlatter","year":"2015","journal-title":"J Cataract Refract Surg"},{"key":"R25-6-20240830","doi-asserted-by":"crossref","first-page":"2425","DOI":"10.1016\/j.ophtha.2012.06.023","article-title":"Corneal epithelial thickness mapping by Fourier-domain optical coherence tomography in normal and keratoconic eyes","volume":"119","author":"Li","year":"2012","journal-title":"Ophthalmology"},{"key":"R26-6-20240830","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.jcrs.2015.09.021","article-title":"Subclinical keratoconus detection by pattern analysis of corneal and epithelial thickness maps with optical coherence tomography","volume":"42","author":"Li","year":"2016","journal-title":"J Cataract Refract Surg"}],"container-title":["Taiwan Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/tjo.tjo_45_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:27:36Z","timestamp":1786735656000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/tjo.tjo_45_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/tjo.tjo_45_20","relation":{},"ISSN":["2211-5056"],"issn-type":[{"value":"2211-5056","type":"print"}],"subject":[],"published":{"date-parts":[[2021,4]]}}}