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Subspecialties Health Economics and Policy

Fall of the Mitey

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Demodex mites are the most common ectoparasite found on humans. An infestation of these miniscule parasites on a person’s eyelashes can cause blockages in the oil glands at the base, leading to Demodex blepharitis, a condition characterized by eyelid inflammation, ocular irritation, redness, and dry eye disease. As people age, Demodex mites can become more prevalent. Patients suffering from chronic rosacea and immunodeficiency disorders have also been found to be more susceptible to infestation.

Studies investigating the prevalence of Demodex blepharitis from the presence of collarettes (1) – cylindrical deposits of waxy buildup found at the lid margin that can be detected by a routine slit-lamp examination – have indicated that the condition affects up to 45 percent of the US population (2). For patients living with the condition, associated psychosocial effects can include depression and anxiety (3).

Tarsus Pharmaceuticals launched its prescription eye drop, Xdemvy 0.25% – the first FDA-approved treatment for Demodex blepharitis (4) – at pharmacies across the US in August 2023. Administered with one drop in each eye, twice daily for six weeks, the lotilaner ophthalmic solution directly targets the Demodex mites, eradicating them by selectively inhibiting the GABA-Cl channels.

To support US patients’ accessibility to Xdemvy, the company has developed Tarsus Connect – a suite of assistance programs to help provide financial support for eligible patients.

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  1. W Trattler et al., “The Prevalence of Demodex Blepharitis in US Eye Care Clinic Patients as Determined by Collarettes: A Pathognomonic Sign,” Clin Ophthalmol, 16, 1153 (2022). PMID: 35449733.
  2. Modern Optometry, “Demodex Screening, Prevalence, and Next Steps,” (2022). Available at:
  3. C Chiang et al., “Patients with Blepharitis Are at Elevated Risk of Anxiety and Depression,” PLoS One, 8 (2013). PMID: 24386181.
  4. Tarsus, “FDA Approves XDEMVY™,” (2023). Available at:
About the Author
Alun Evans

Coming from a creative writing background, I have a great interest in fusing original, narrative-driven concepts with informative, educational content. Working at The Ophthalmologist allows me to connect with the great minds working in the field of contemporary eye care, and explore the human element involved in their scientific breakthroughs.

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