Potential Role of Ocular Demodex Infestation in Eyelid Eczema

Background: Eyelid eczema includes a heterogeneous group of inflammatory dermatologic conditions affecting the periocular region. Although these disorders often present with similar clinical features, their etiologies are distinct. Aim: We aimed to establish demodex infestation as a cause of eye lid eczema. Methodology: Patients diagnosed with eyelid eczema were enrolled in the study from April 2024 to December 2024. An age and gender matched control group was formed from healthy volunteers. Each patient had a detailed ophthalmic evaluation, and two lashes were removed from each eye, then eyelashes were examined directly under light microscopy for the presence of Demodex mites. Results: A total of 58 patients with eyelid eczema and 46 healty controls were enrolled the study. Demographics were similar between groups. Demodex infestation was found more prevalent in patients with eyelid eczema compared to the control group (31% in the eczema group, 13% in the control group, p-value= 0.03 Participants with demodex infestation had a threefold higher likelihood of having eyelid eczema compared to the control group. Conclusion: When evaluating eyelid eczema, Demodex infestation should not be overlooked.