FDA Approves First Eyedrops to Treat Mites Living on Eyelashes

More than 25 million Americans are living with Demodex blepharitis, an underdiagnosed condition that involves mites living on a person’s eyelashes.

Demodex blepharitis has gone underdiagnosed for decades because of a lack of treatment options, but a new solution was recently approved by the US Food and Drug Administration: lotilaner ophthalmic solution, available under the trade name Xdemvy (Tarsus Pharmaceuticals).

Himani Goyal, MD, an ophthalmologist at NYU Langone Health and Chief of Ophthalmology at NYC Health + Hospitals/Bellevue, led a roundtable discussion in New York City on June 6 to give her insights on the condition, which often comes to the attention of dermatologists as well.

Goyal explained that the mites flourish on the eyelid because it is a wet and moist area from the eye’s tear ducts.

While the mites are too small to see with the naked eye, some symptoms Demodex blepharitis causes are redness and irritation around the eyelids; some patients may have difficulty keeping eyes open and, as a result, may feel or look like they are overly tired. The irritation from the symptoms comes from debris left behind by the mites building up on the eyelid.

It’s also possible, and even likely, that people are living with eyelash mites and have no idea.

The goal of prescribing patients the new eye drops is to eradicate the bacteria. The mites become paralyzed over the course of six weeks of twice-daily drops.

This condition can impact all genders, ethnicities, and age groups, but one thing Dr. Goyal notes is anything that stops the natural process of eyelash shedding, which she says happens every three weeks, can make someone more susceptible to Demodex blepharitis.