Describing the Real-World Burden of Demodex Blepharitis: A Multicenter Audit in a UK Public Specialist Eye-Care Setting

Author(s)

Rosa Willock, MSc1, Mayank Nanavaty, MD2, Emil Kurniawan, MD3, Radhika Rampat, MD3, David Lockington, MD4, S.J Ting, MD5, Patrick Adams, AB1, Theoni Demcollari, PhD1, Elizabeth Yeu, MD6.
1Decisive Consulting, London, United Kingdom, 2University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom, 3Royal Free Hospital NHS Foundation Trust, London, United Kingdom, 4Tennent Institute of Ophthalmology, Glasgow, United Kingdom, 5University of Birmingham Academic Unit of Ophthalmology, Birmingham, United Kingdom, 6Tarsus Pharmaceuticals, Irvine, CA, USA.
OBJECTIVES: Blepharitis is an inflammatory external eye disease, two-thirds of which is caused by overgrowth of Demodex mites. This form, known as Demodex blepharitis (DB), is identified by a pathognomonic sign - collarettes - at the base of the eyelashes. DB can lead to a range of ocular symptoms but is often undiagnosed or misdiagnosed. There is a lack of data related to the burden of illness. This audit aimed to explore DB burden by prevalence, patient characteristics, treatment patterns, and healthcare resource utilisation (HCRU).
METHODS: A cross-sectional retrospective audit was conducted across five public specialist centres in the UK. Patients aged 18 years or older attending scheduled eye appointments and undergoing a slit-lamp examination were consecutively included. Patients with active ocular infection or lid structural abnormalities were excluded. Data were collected during the visit and retrospectively over 3 years. Patients were stratified into DB and non-DB groups, with DB being defined as having ≥1 collarette, consistent with U.S. and Japanese precedent. This abstract reports interim data for DB patients collected in June 2025. Data were analysed using descriptive statistics.
RESULTS: Among 286 patients in the interim dataset, 53.5% (n=153) had ≥1 collarette (mean age, 65.9 years; 49.0% female) and classified as having DB. Of these, 39.2% (n=60) had >10 collarettes. Common symptoms of the DB patients included dry-eyes/tearing (77.1%), burning/stinging (56.2%), itchy eyelids (55.6%), ocular redness (49.7%), and visual fluctuation (49.7%). Comorbidities included dry-eye (81.7%), meibomian gland dysfunction (79.1%) and cataracts (31.4%). The reported treatments varied, including artificial tears (73.2%), lid hygiene products (41.8%), and topical steroids (35.3%).
CONCLUSIONS: To our knowledge, this is the first study to explore DB burden in a UK public specialist eye care setting. DB patients show symptom burden and multiple ocular comorbidities, while receiving non-Demodex-specific treatments and experiencing unresolved symptoms, signalling a high unmet need.

Conference/Value in Health Info

2025-11, ISPOR Europe 2025, Glasgow, Scotland

Value in Health, Volume 28, Issue S2

Code

HSD32

Topic

Economic Evaluation, Health Service Delivery & Process of Care

Disease

Sensory System Disorders (Ear, Eye, Dental, Skin)

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