Murphy 2018.

Study characteristics
Methods	Study design: randomized controlled trial Study grouping: parallel group; multi‐arm Power/Sample size calculation: NR
Participants	Baseline characteristics Group A: Dr. Organic TTFW Number of participants: 22 Age – mean: 49.6 (SD 17.1) years Women %: NR Demodex count per 4 eyelashes – mean: 4.9 (range: 0–21) OSDI score – mean: 27.4 (SD 16.7) Visual acuity: NR Number of cylindrical dandruff: NR Group B: OcuSoft Lid Scrub Plus Number of participants: 24 Age – mean: 49.6 (SD 16.9) years Women %: NR Demodex count per 4 eyelashes – mean: 3.8 (range: 0–11) OSDI score – mean: 28.6 (SD 23.6) Visual acuity: NR Number of cylindrical dandruff: NR Group C: BlephEx microblepharoexfoliation device Number of participants: 23 Age – mean: 49.86 (SD 19.7) years Women %: NR Demodex count per 4 eyelashes – mean: 6.5 (range: 1–25) OSDI score – mean: 30.1 (SD 19.8) Visual acuity: NR Number of cylindrical dandruff: NR Overall Number of participants: NR Age: NR Women %: NR Demodex count per 4 eyelashes: NR OSDI score: NR Visual acuity: 1.08 (SD 0.26) Number of cylindrical dandruff: NR Inclusion criteria: aged > 18 years Exclusion criteria: ocular surgery in the past 6 months, or undergoing current ophthalmic treatment Pretreatment: individual groups seemed to be balanced; however, their unorthodox control groups were small and younger than the people within their respective groups.
Interventions	Intervention characteristics Group A: Dr. Organic TTFW Dr. Organic TTFW contains 38% terpinen‐4‐ol, the most active ingredient in TTO shown to be effective at killing Demodex folliculorum in a dose‐dependent manner Frequency (or dosing schedule): daily once at night Concentration: 38% terpinen‐4‐ol Group B: OcuSoft Lid Scrub Plus The active ingredient in OcuSoft Lid Scrub Plus wipes is 1,2‐octanediol; a substance which has been shown to have pediculicide potential Frequency (or dosing schedule): daily once at night Concentration: 0.5% 1,2‐octanediols Group C: BlephEx microblepharoexfoliation device BlephEx is a patented hand‐held device, developed for the treatment of ocular surface disorders including blepharitis. The apparatus consists of a hand‐held electromechanical unit and a disposable micro‐sponge inserted in the chuck that spins rapidly to provide debridement and exfoliation at the lash margin. Frequency (or dosing schedule): at baseline visit only Concentration: 0%
Outcomes	Mean severity of symptoms score (via modified version of the OSDI dry eye questionnaire); habitual visual acuity (LogMAR); slit lamp exam to assess and grade presence of cylindrical dandruff; and assessment for presence of Demodex.
Identification	Sponsorship source: materials used in study supplied by Scope Ophthalmics and Dr. Organic Ltd. Country: Ireland Setting: Dublin Institute of Technology Comments: none Authors name: Orla Murphy Institution: Dublin Institute of Technology Address: NR Clinical trial registry/registration number: NR
Notes	Each of the three arms also includes "control" participants who did not have Demodex follicurlorum
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Judgment comment: participants were asked to choose a number from a list. Each number corresponded to a treatment.
Allocation concealment (selection bias)	Unclear risk	Quote: "Each subject chose a number from the list, which corresponded to the treatment assigned to the subject." Judgment comment: information not provided.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Quote: "The examiner was blind to the treatment throughout all stages of the study for group A and group B. The examiner performed the BlephEx™ treatment on subjects from group C and was therefore not blind to the treatment in this group." Judgment comment: examiner knew who was in 1 of the groups, and the participants knew which group they were in.
Blinding of outcome assessment (detection bias) All outcomes	High risk	Quote: "The examiner performed the BlephEx™ treatment on subjects from group C and was therefore not blind to the treatment in this group."
Incomplete outcome data (attrition bias) All outcomes	Low risk	Judgment comment: there is sufficient explanation provided for all analysis. No missing data reported
Selective reporting (reporting bias)	Unclear risk	Judgment comment: no prepublished protocol listed, so we could not determine if there was selective reporting.