A Case of Corneal Opacity Improved by Treatment of Demodex Blepharitis

Jung Huh; Kyoung Woo Kim; Jae Chan Kim

doi:10.3341/jkos.2014.55.10.1558

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Huh, Kim, and Kim: A Case of Corneal Opacity Improved by Treatment of Demodex Blepharitis

Case Report

J Korean Ophthalmol Soc 2014;55(10):1558-1561.

Published online: 2 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.10.1558

A Case of Corneal Opacity Improved by Treatment of Demodex Blepharitis

Jung Huh, MD, Kyoung Woo Kim, MD, Jae Chan Kim, MD, PhD

Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea

Address reprint requests to Jae Chan Kim, MD, PhD, Department of Ophthalmology, Chung-Ang University Hospital, #102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Korea, Tel: 82-2-6299-1666, Fax: 82-2-6299-3231 E-mail: jck50ey@hanmail.net

Received 1 May 2014 Revised 11 July 2014 Accepted 17 September 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of corneal opacity improved by treatment of demodex blepharitis.

Case summary

A 50-year-old female who received sub-laser-assisted in situ keratomileusis (LASIK) flap surgery was referred to our clinic with corneal opacity and neovascularization in her left eye. Her visual acuity was 0.5. Telangiectasis of the eyelid margin and meibomian gland dysfunction were observed. Seven Demodex folliculorum were found in 4 eyelashes of the left eye. Lid scrub with 0.4% polyhexamethylene biguanide (PHMB) and ointment containing dexamethasone was started for demodex blepharitis treatment. After 6 months of treatment, the number of Demodex folliculorum was decreased to 2 and the best corrected visual acuity was 0.8. Corneal opacity and neovascularization were also improved.

Conclusions

The present study showed that demodex blepharitis can induce atypical corneal opacity and neovascularization after LASIK surgery. Evaluation and treatment of demodex blepharitis in these patients is important.

Keywords: Corneal neovascularization, Corneal opacity, Demodex blepharitis LASIK, LASIK

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Figure 1.

Photographs of slit-lamp biomicroscopy and anterior optical coherence tomography (OCT) of 50-year-old female with corneal opacity associated with neovascularization and demodex blepharitis of her left eye. (A, B, C) Sub-laser-assisted in situ keratomileusis (LASIK) flap opacity and neovascularization was noted on inferior cornea before treatment of demodex blepharitis. (D) Anterior OCT showed sub-LASIK flap infiltration of opacity (white arrow).

Figure 2.

Photographs of cornea, eyelid margin, and demodex before (A, B, C) and after (D, E, F) the treatment of demodex blepharitis. (A, B) Slit-lamp photographs of cornea and eyelid before demodex blepharitis show the definite corneal opacity hiding the underlying iris morphology (white arrow) associated with neovascularizations (black arrow heads) and the lid margin edema with meibomian orifice plugging. (C) There was multiple species of demodex folliculorum. (D, E) After the 1 year-treatment, corneal opacity (white arrow) and associated new vessels (black arrow heads) were much dimmed and eyelid margin edema and engorgement were also improved. (F) The count of the demodex was much decreased after the treatment.

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