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Nowadays chronic blepharitis that does not respond to conventional treatment is associated with increasing number of Demodex at eyelid. In human eye, there are two species of mites which are Demodex folliculorum and Demodex brevis. Due to their habitat of these 2 species are different which cause different kind of anterior and posterior blepharitis, respectively. Ocular symptoms of Demodex blepharitis are overlap to the other ocular surface disease but symptoms may worsen than the others. This reason may be the cause of delayed diagnosis and ineffective management of Demodex blepharitis. Pathognomonic sign of this disease is the cylindrical dandruff around lash follicle. There are many methods for confirm diagnosis which the most popular method is lash sampling and exam under microscope. Mode of common treatments presently, there are many commercial eyelid cleansers that contained tea tree oil in various concentration in the market or oral ivermectin but all of these cannot get rid of Demodex mite after 4 weeks of treatment. So Demodex blepharitis is the chronic disease that challenges both diagnosis and proper treatment for the quality of chronic blepharitis patients in the future.
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