One morning, a young mother brought her three-year-old daughter to the ophthalmology clinic of Tsinghua Changgeng Hospital in Beijing. It turned out that the young mother had repeatedly experienced redness, itchy eyes, burning sensation in the eyes with a small amount of secretions in the past six months, and often lost eyelashes. The child developed similar symptoms about a month ago, but with more yellow eye droppings. Severe eye discomfort, so that the mother and daughter have been repeatedly treated in a number of hospitals, the diagnosis is always "conjunctivitis" and "dry eye", but also continue to receive "levofloxacin", "pramerofen", "sodium hyaluronate" and other eye drugs combined treatment. Although the child's eye droppings have been reduced, the symptoms of red eyes and itchy eyes in the two people are still the same.
Through the examination of the slit lamp microscope, as the receiving doctor, I found that the mother and daughter had scaly secretions at the base of the eyelashes of both eyes, like a small sleeve wrapped around the base of the eyelashes. At the same time, the skin at the eyelid margin is reddish and the conjunctival congestion is pronounced. In terms of signs and symptoms, mite infection is most likely. So I pulled out five eyelashes from each of my mother's eyes and sent them for examination, and found that more than half of the eyelashes had mites parasitic at the base, and the most eyelashes found four adult worms at the same time.
The culprit was finally found. The mother and daughter were diagnosed with conjunctival disease associated with mite blepharitis, and the occurrence of conjunctival lesions in both was closely related to mite infection of the eyelid margin skin. Only by completely killing mites can we cure the problem of "red eyes and itchy eyes".
The demodex mite is a tiny human parasite. Unlike dust mites on pillows, it often infects the skin follicles and sebaceous glands at the edge of the eyelids, causing itchy eyes, redness, eye irritation and burning sensations. Severe cases can induce chronic conjunctivitis, dry eye, and even keratitis, which usually recur and do not heal. There is also dermatitis that may cause eyelids, such as blepharitis (commonly known as rotten eye margins), inverted eyelashes, eyelashes loss, and multiple meibomian gland cysts (repeated long eyelid cysts).
How can I find out if my eyes are infected with mites? Use small forceps to remove three eyelashes from the upper and lower eyelids of both eyes, place them under a microscope, and then start looking for demodex mites.
The most commonly used medicine to treat mite infections is tea tree oil, a pure natural plant essential oil extracted from melaleuca leaves of the Myrtle family. This is not the oil we use for stir-frying, it was first used by Australian residents to treat wounds and skin infections. Although the treatment effect of tea tree oil is good, its treatment course is long, and it has a certain irritation to the eye area, and some users will have allergic reactions. In search of a better drug, after analyzing tea tree oil, it was found that the main active ingredient was 4-terpinol. The latest research shows that 4-terpineol has better anti-inflammatory and antibacterial effects than tea tree oil, and can effectively kill mites.
Treatment of mite infestation: the patient after applying a warm compress to the eye and thoroughly wiping off the secretions of the skin at the edge of the eyelids. The skin on the eyelids, forehead and nose and cheeks can be repeatedly wiped with 4-terpine oil wipes. Such treatment requires more than four consecutive weeks, as the demodex mite completes its life cycle from egg to adult death in 14-15 days. The treatment time is usually two life cycles of mites. In addition, the patient's personal hygiene products should be extinguished by high temperature every week, such as face towels, pillow towels, and underwear. High temperatures above 58 °C can kill mites. It is worth mentioning that mites are acid and alkali resistant, and commonly used cleaning products, 84 disinfectant and iodine have no killing effect on mites.
Prevention of mite infection: We should pay attention to improving the indoor environment and preventing mite breeding every day. Maintain indoor air circulation, suitable humidity; regular cleaning and frequent drying of pillowcases and duvet covers, regular change of bed sheets, water temperature should be controlled above 58 ° C to kill mites during cleaning; strengthen exercise, enhance their own resistance; pay attention to personal hygiene, strengthen eye cleanliness; avoid using the same textiles, such as towels, etc. with mite infection patients.
Text/Liu Xuan (Tsinghua Changgeng Hospital, Beijing)
Source: Beijing Youth Daily