Hey doc why are my eyes so red? Word from the Miami Beach eye care specialists is that it is possibly not just dry eye.  It could be an eyelid infestation of demodex mites!

In South Beach, Miami Beach eyelid appearance seems to be a priority with our patients. Our optometrist has found more and more patients are under-diagnosed or misdiagnosed with the cause of chronic red and dry eyes. The cause may be significantly different than you imagine and Visine is certainly not the cure!  The eyelids are the gatekeepers to our entire ocular system. There are many inflammatory conditions that can affect this region of the eye. Bacteria, demodex mites and other gross critters can infest our eyelashes.


Most commonly patients are diagnosed with three types of lid inflammation involving different parts of the eyelids. These can be broken down into the anterior eyelash region and the posterior meibomian gland region, or a combination of the two.


There are many causes of the anterior inflammatory condition called anterior blepharitis. One of the most common is a staph bacteria overgrowth leading to debris and oil flakes that can crust over the eyelashes, such as how dandruff does on our hair. These can be managed with an antibacterial lid scrub and often an antibiotic ointment at bedtime. Diagnosis of this can only be made by a microscopic examination at the eye doctor’s office. Another increasingly diagnosed cause of anterior lid disease is a mite infestation. Demodex mites commonly inhabit the body in small colonies, but can proliferate and inhabit the areas around the follicles of the eyelashes leading to significant irritation, redness and flaking. This can be a contributor to dryness and ocular surface irritation. These mites are difficult to eradicate and must have a specific formulation of tea-tree oil, which is found in the new lid formulation Cliradex.  This lid wipe is applied on the eyelids once or twice a day for several months, then a few times a week for regular maintenance to maintain clean lashes. This as well as good cleaning of bedding and towels can reduce the chance of overgrowth again. The only real diagnosis comes from signs noticed during a microscopic examination at your eye doctor’s office. These little guys are gross and one of the creepiest types of inflammatory conditions we find on eyelids that can be easily treated once identified.

The posterior lid inflammatory conditions are known as posterior blepharitis, meibomian gland dysfunction and meibomitis. They involve the meibomian glands. These oil glands are just posterior toward the surface of the eye from the eyelash margin. These glands produce an oil called meibum which secretes out with every blink coating our tears with a nice oil layer protecting the tear film and keeping it from evaporating. Small blood vessels around these glands can become inflamed, clogging them and bacteria can also become rampant in these clogged glands. This causes significant irritation, back up of the oil and leads to infectious eyelid disease such as internal hordeola, which can be dangerous to the tissues around the eye and lead to hard masses that must be surgically removed if not treated properly. The way that we treat this condition is to use regular lid hygiene involving warm compresses over the lids for 5 to 10 minutes, once or twice a day, as well as anti-inflammatory agents such as omega-3 supplementation and doxycycline antibiotic pills. Topical eye drops such as azithromycin can also help with their anti-microbial and lipophilic mechanisms breaking up the oil and killing off the bacteria.


Many patients have a combination of these lid conditions and are often misdiagnosed as having dry which is treated with artificial tears or red-eye reducing agents by the patient self-diagnosing the causative reason for their ocular irritation. If you have not had an eye examination within the last 12 months, this is the only way to find out if you have inflammatory conditions which can lead to discomfort and chronic redness of the eyes.  These can easily be treated once diagnosed.


At South Beach Vision we are experts in ocular surface and lid disease and treat hundreds of patients for this condition. We are the Miami Beach Eye Doctor Specialists for dry eye and blepharitis.  We specialize in the diagnosis and treatment of the mite infestation by Demodex.


Please call us today to set up your comprehensive eye examination. Conveniently located in South Beach Miami Beach our optometrist is the only American Board of Optometry nationally board-certified optometrist in all of Miami Beach. We will take the time to thoroughly evaluate your condition and give you a personalized treatment regimen which will drastically improve how your eyes feel.  Proper identification and treatment will reduce the risk of future damage to your ocular surface and eyelids. We carry several products which can help alleviate these conditions in the office. So we are able to diagnose, treat, prescribe and dispense everything all in one place. We are at your Miami Beach eye specialty experts, here to serve the South Beach community.  Please do not hesitate to call or text us for your eye exam today at 305-877-2026.

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