Clinical characteristics and preliminary retrospective evidence of adjunctive efficacy of intense pulsed light therapy for Demodex-associated blepharokeratoconjunctivitis: a single-center study.

OBJECTIVE

To characterize clinical features of Demodex blepharokeratoconjunctivitis (BKC) and evaluate the efficacy of intense pulsed light (IPL) adjunctive therapy.

METHODS

Retrospective cohort study of 45 microbiologically confirmed Demodex-BKC patients. Outcomes were compared between conventional treatment (n = 35) and IPL-adjunctive groups (n = 10).

RESULTS

Corneal lesions predominantly involved the inferior cornea, with characteristic lid margin signs including cylindrical dandruff and recurrent chalazia. Significant diagnostic delays and frequent misdiagnosis were observed. Higher Demodex density strongly correlated with increased corneal lesion severity, central corneal involvement, and worse meibomian gland dysfunction. IPL adjunctive therapy demonstrated significantly superior outcomes versus conventional treatment: greater neovascularization regression, improved tear film stability, better visual acuity gain, and reduced 6-month recurrence. Treatment was well-tolerated without adverse events.

CONCLUSION

In this retrospective study, IPL adjunctive therapy was associated with improved clinical outcomes in Demodex-BKC, including reductions in mite burden, inflammation, and recurrence risk. These findings suggest it may represent a promising adjunctive therapeutic strategy.