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Demodex Patient Case #1

Opinion
Video

Amy Nau, OD, discusses a challenging case of Demodex infestation in a 32-year-old male suffering from severe anxiety due to Rosacea and Demodex.

This is a video synopsis of a discussion involving Amy Nau, OD, Dipl CCLRT, focusing on Demodex blepharitis cases presented at the CRU symposium as a roundtable discussion with Optometry Times.

The first case discussed is that of Blake, a 32-year-old white male who experienced trauma to the left eye with a tennis ball in Spain. He complained of recurrent corneal erosions, which were unresponsive to previous treatments. Examination revealed positive Demodex findings, obstructive meibomian gland dysfunction, mild facial rosacea, and basement membrane dystrophy. Blake's treatment plan involved a bandage contact lens for corneal erosions, poly trim coverage, and an option for amniotic membrane contact lenses, though declined due to anxiety.

For meibomian gland dysfunction, Demodex, and rosacea, Dr. Nau recommended four intense pulsed light (IPL) sessions, an iLux mask for warm compresses, and Retaine MGD (non-preserved lipid-based drop). Blake's regimen also included artificial tears reduction, Muro 128 Ointment, and lifestyle adjustments. At the two-month follow-up, vital tears were introduced based on confocal microscopy findings. By four months, the recurrent corneal erosion healed, but meibomian gland dysfunction persisted, leading to additional IPL sessions and LipiFlow.

Blake faced challenges with obsessive-compulsive disorder and anxiety. Dr. Nau emphasized the importance of addressing multiple conditions systematically, considering the patient's acute distress, and prioritizing treatments based on urgency. The video highlighted the role of Demodex in inflammation and swelling, disrupting meibomian gland function and causing recurrent corneal erosions. The discussion also touched on the occurrence of delusional parasitism in patients with anxiety issues, necessitating collaboration with mental health teams.

In conclusion, Dr. Amy Nau's comprehensive approach addressed various ocular conditions, emphasizing the need to tailor treatments to individual patient needs, considering both physical and mental health aspects.

Video synopsis is AI-generated and reviewed by Optometry Times® editorial staff.

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