UNITED KINGDOM DEMODEX BLEPHARITIS BURDEN: CLINICAL AUDIT WITH A PATIENT PERSPECTIVE
Published 2026 - 30th ESCRS Winter Meeting
Reference: FP07.10 | Type: Free Paper | DOI: 10.82333/7tyz-hp04
Authors: Mayank Nanavaty* 1 , Emil Kurniawan 2 , Darren Shu Jeng Ting 3 , Radhika Rampat 2 , Rosa Willock 4 , Theoni Ingrid Demcollari 4 , James Mun 5 , Elizabeth Yeu 5 , David Lockington 6
1Sussex Eye Hospital,University Hospitals Sussex NHS Foundation Trust,Brighton,United Kingdom, 2Ophthalmology,Royal Free London NHS Foundation Trust,London,United Kingdom, 3Ophthalmology,Birmingham & Midlands Eye Centre,Birmingham,United Kingdom, 4Decisive Consulting,London,United Kingdom, 5Tarsus,Irvine,United States, 6Ophthalmology,Tennent Institute of Ophthalmology,Glasgow,United Kingdom
Purpose
To explore the burden of Demodex blepharitis (DB) on the UK healthcare system by estimating the proportion of DB among routine secondary-care ophthalmology attendees and describing clinical burden, treatment patterns, and healthcare resource use (HCRU).
Setting
Cross-sectional, retrospective audit across five UK NHS specialist eye centres and online survey of adults in the UK.
Methods
Adults (≥18 years) attending routine eye appointments with slit-lamp examination were audited; exclusions included active ocular infection or lid structural abnormalities. DB was defined by collarettes: non-DB (no collarettes), mild DB (1–10), and moderate–severe DB (>10). Online survey participants had clinician-diagnosed DB/blepharitis or ≥3 recurrent symptoms (itching, dryness, crusts/debris) without formal diagnosis; results presented from the diagnosed cohort. Descriptive statistics, comparative tests, and regression analyses were used.
Results
Among 493 audited attendees (mean age 59.8±19.6 years; 50.7% female), 57.8% had ≥1 collarette (DB) and 24.1% had moderate–severe DB. DB prevalence was higher in glaucoma (88.6%), rosacea (88.5%), meibomian gland dysfunction (78.1%), and dry eye disease (71.8%). Symptom burden increased with severity: 90.2% of DB patients reported ≥1 ocular symptom; moderate–severe DB showed >2.5-fold odds of high symptom frequency versus mild (95% CI 1.3–4.8; p=0.005). Treatments were non-specific: artificial tears (84.0%), lid hygiene (38.5%), topical steroids (38.5%), cyclosporin (21.0%), with cyclosporin 2.7-fold more likely in moderate–severe vs mild disease (p=0.009). Among DB outpatients (n=189), mean per-patient per-year all-cause visits exceeded benchmark by 1.6–2.2 times. The online survey (n=43 UK DB/blepharitis patients; mean age 52.7±15.2 years; 60.4% female) reported long symptom duration (5.8 years), daily symptoms (90.6%), frequent advice-seeking (mean 7.6 doctor visits), and similar non-specific therapy patterns, with notable out-of-pocket costs mirroring audit findings.
Conclusion
DB signs are common in UK specialist eye-care settings and associated with substantial symptom burden, multiple non-specific therapies, and elevated visit rates. Patient-reported patterns align with audit data, highlighting persistent impact and need for targeted DB treatments.