Efficacy of 1% Ivermectin Ointment for Demodex Blepharitis

Purpose: We evaluated the efficacy of topical 1% ivermectin ointment in treating chronic Demodex blepharitis by comparing Demodex mite density before and after treatment. In addition, we assessed changes in eyelid cylindrical dandruff and telangiectasia. Methods: In total, 38 patients suspected of Demodex blepharitis were included. Following the epilation of eyelashes and confirmation of mites, topical 1% ivermectin ointment was applied once weekly for 8 weeks. We analyzed the change in mite density per eyelash and the severity scores of upper eyelid cylindrical dandruff and telangiectasia before and after treatment. Results: We included 38 patients (mean age, 61.8 ± 10.7 years; 15 men and 23 women) with suspected Demodex blepharitis. Topical 1% ivermectin ointment applied once weekly for 8 weeks led to a statistically significant reduction in the mite density per eyelash, severity of upper eyelid cylindrical dandruff, and upper eyelid telangiectasia (p < 0.001, p < 0.001, and p = 0.008, respectively). Notably, no complications such as corneal epithelial defects were observed. Conclusions: Topical 1% ivermectin ointment demonstrated exceptional efficacy, nearly eradicating Demodex infestations in patients with Demodex blepharitis. This resulted in significant improvements in upper eyelid cylindrical dandruff and telangiectasia.