Updates in the Management of Demodex Blepharitis - Episode 3
Douglas K. Devries, OD, discusses how Demodex blepharitis affects patients’ quality of life and associated financial burden.
Douglas K Devries, OD: Let’s talk about misdiagnosis or underdiagnosis, which fall into the same category. Quite often, it’s underdiagnosed. Patients come in and complain. They have dry eye symptoms, and this is a source of inflammation that causes exacerbation of dry eye symptoms. Not looking and underdiagnosing or misdiagnosing means that you’re treating an incorrect element of the underlying physiology of that patient. You may be applying treatments and not getting results, causing further visits, further costs, and frustration for the patient. The cost of underdiagnosis and misdiagnosis is extremely high. You’re missing the element that could help give that patient more comfort and decrease some of their dry eye signs. Some of those signs are mixed together in terms of what happens when those inflammatory mediators are released onto the eye.
How could Demodex affect a patient’s life? Discomfort. Patients aren’t comfortable. Their eyes are irritated. It’s important to remember that inflammation is inflammation, and the eye doesn’t care what it is, whether it’s just from dry eye, allergy, or Demodex. It’s going to be 1 more source that’s going to limit that individual in their daily activities, and it compounds. It’s rarely the entire cause of the patient’s discomfort, but in many cases, it’s a major contributor. The patient may not be able to conduct their activities without some element of discomfort, which causes a lot of frustration with our patients.
Let’s talk about the economic impact that Demodex might have on patients. No studies have been conducted on the economic impact, but there have been studies on the economic impact of dry eye. Being part of the underlying etiology, you can safely include that with dry eye because it’s a component that drives that. When we look at the economic burden of dry eye, the direct financial cost of the medical treatment is about $3.6 billion. A much more interesting number is loss of activity, loss of time, and loss of productivity, which is estimated to be in excess of $40 billion in dry eye.
As I talked about earlier, with Demodex being a component of dry eye and causing that irritation, it’s difficult to completely separate Demodex from the economic and productive impact of a patient having dry eye disease: the lost time at work, the nonproductivity, and not showing up to work. Because it’s a component, you have to include that. Even though there haven’t been specific economic studies on the impact of Demodex, it becomes part and parcel of that whole economic impact that has been studied with dry eye disease.
Transcript edited for clarity.