Intense Pulsed Light Combined With Low Level Blue And Red Light Therapy For Demodex-Associated Blepharitis

Demodex-associated blepharitis is a chronic disease of the lid accounting for over 60% of all blepharitis. Although several therapies have been employed to address Demodexmites’ infestation, there is no universal consensus about the most effective strategy. The purpose of this study was to evaluate the efficacy of combined intense pulsed light (IPL) and low-level light therapy (LLLT) in the treatment of Demodex-associated blepharitis.

Eye Clinic, University Hospital.

Medical records of patients with Demodex-associated blepharitis resistant to first-line therapy who underwent IPL and LLLT (12 minutes of blue light followed by 12 minutes of red light) were retrospectively examined. The following data collected before treatment (T0) and at last follow-up (T1) were reviewed: symptoms (5-item Dry Eye Questionnaire [DEQ-5]); collarettes (0-4 grade); saponification (presence/absence); lid margin telangiectasia (0-3 grade); conjunctival hyperemia (0-4 grade); corneal fluorescein staining (CFS) (0-5 grade); noninvasive tear break-up time (NITBUT), tear meniscus height (TMH), inter-blink interval (IBI), meibomian gland dropout (0-3 grade). Treatment-related adverse effects (TrAEs) were recorded.

Data from 34 eyes of 17 patients (3 males, 14 females; mean age 64.6±10.0 years) were included. A mean of 7.6±3.6 treatment sessions of IPL and LLLT was performed. Mean score of collarettes decreases significantly from 1.44±0.83 at T0 to 1.00±0.97 at T1 (p=0.007). The rate of eyes with saponification decreases significantly (from 41.18% to 11.76%; p=0.002). Conjunctival hyperemia significantly decreased from 2.00±0.78 to 1.47±0.61 (p=0.005). Mean CFS score decreased significantly from 0.56±1.16 to 0.24±0.96 (p=0.031). Symptoms’ mean score improved significantly after treatment (from 12.00±5.34 to 7.76±4.92; p=0.003). No patient reported TrAEs during or after treatment.

Combined light therapy with IPL and LLLT employing blue and red lights is an effective treatment strategy for patients with recalcitrant Demodex-associated blepharitis to reduce mites count and improve main ocular surface parameters along with patients’ symptoms.