TABLE 3.
Perspectives on Diagnosis and Management of Demodex Blepharitis
| Perspectives in diagnosis |
| “What we did not know until recently was the profound effect that Demodex blepharitis has on patient quality of life, lid margin disease, and ocular surface disease…Whether they are coming for a regular eye exam, for a cataract evaluation, glaucoma, contact lenses, or dry eye, there is a large percentage of that population in any one of those categories that has Demodex blepharitis…it is an equal-opportunity mite.” —Doctor of optometry specializing in dry eye |
| “We used to think you have to pluck an eyelash and look at it under the microscope to see the mites, but you don’t need to do that.” —Ophthalmologist and cornea and cataract ophthalmic surgeon |
| “What we did not know until recently was the profound effect that Demodex blepharitis has on patient quality of life, lid margin disease, and ocular surface disease.” —Ophthalmologist and cornea, laser cataract, and refractive surgeon |
| “We didn’t know how common [Demodex] was because we weren’t looking for it. Now that we look for it, it has been hiding in plain sight” —Doctor of optometry specializing in dry eye |
| Perspectives in treatment |
| “Previously, I would put patients on tea tree oil–based wipes and have patients do these 2 or 3 times a day, basically indefinitely, just to keep their mite load at bay, but compliance was very poor.” —Ophthalmologist and cornea and cataract ophthalmic surgeon |
| “[Earlier adjunctive management treatments included] artificial tears…warm compresses…and Johnson’s baby shampoo, none of which were particularly effective and offer only temporary symptom relief.” —Ophthalmic assistant |
| “We had a patient in Boston last week who saw 15 different eye care professionals…patients like these are obviously frustrated, but they also come in with other medications they’ve tried and show us all the things that did not work…[but following treatment with lotilaner] the patients are happier with their therapy and they’ve simplified their lives…we’ve also made it less expensive.” —Ophthalmologist and cornea, laser cataract, and refractive surgeon |
| “[Findings with lotilaner represent] a really dramatic impact of clearing out those lashes with a 6-week treatment twice daily. In SATURN-1…the majority of patients still had a significant treatment effect and benefit after 1 full year.” —Ophthalmologist and cornea and cataract ophthalmic surgeon |
| “What really impressed me with the efficacy data or the long-term data is that even the redness of the eyelids improved over time. It actually [improved] between the primary endpoint at around 6 weeks and a year later when they did the extension study.” —Doctor of optometry specializing in dry eye |
| “The only thing recently that compares with that same euphoria of restoring vision is when you take a patient with a chronic disease that has been bothering them for a decade…and you solve it with a very simple drop twice a day. The euphoria and gratitude of these patients who’ve been placed on lotilaner [ophthalmic solution 0.25%] is one of the most remarkable aspects.” —Ophthalmologist and cornea, laser cataract, and refractive surgeon |
| Resource utilization |
| “With one therapy for 6 weeks, studies show the effect lasts for a full year…The alternative for many of these patients is 12 prescriptions prescribed of medications that are more expensive over the course of a year….[and] the cost of using an immunomodulator [such as cyclosporine eye drops or lifitegrast eye drops] is dramatically higher than the cost of using lotilaner [ophthalmic solution 0.25%]…I will make the very strong statement that use of lotilaner [ophthalmic solution 0.25%] saves payers money.” —Pharmacist and payer representative |
| “Overwhelmingly, my patients are extraordinarily happy, number 1, but number 2, I’m simplifying their regimen…They are using less medication…I think at the end of the day, this is going to be a cost savings to the insurance companies and the third-party payers when you make the right diagnosis” —Ophthalmologist and cornea, laser cataract, and refractive surgeon |
| “Optometry colleagues of mine are sending over a fair amount of [patients who cannot wear contact lenses anymore]…Patients would come in with a dry eye diagnosis or contact lens intolerant, and I was surprised how often we saw Demodex blepharitis…Most of my colleagues are coming up with the diagnosis [without need to consult additional eye care specialists].” —Doctor of optometry specializing in dry eye |
| “I used to take [artificial tears] 2 or 3 times an hour… Since treatment with [lotilaner], I find I’m not really using the [artificial tears] as often. I have them with me because I’ve been carrying them around in my pocket all the time for years. It has made an amazing difference to my daily life and what I do.” —Patient with Demodex blepharitis treated with lotilaner |