Clinical Scorecard: Contact Lens Dropout? Start With the Lids

At a Glance

Key Highlights

• 93% of soft contact lens dropout patients have Demodex mites.
• MGD is present in about 60% of contact lens wearers.
• Collarettes at the base of eyelashes confirm Demodex blepharitis.
• Lotilaner 0.25% is FDA-approved for treating Demodex blepharitis.
• Ivermectin 1% cream can significantly improve symptoms of Demodex blepharitis.

Guideline-Based Recommendations

Diagnosis

• Examine lid margins for collarettes to diagnose Demodex blepharitis.

Management

• Treat with lotilaner 0.25% ophthalmic solution or ivermectin 1% cream.

Monitoring & Follow-up

• Assess improvement in symptoms and meibomian gland function after treatment.

Risks

• Increased discomfort and dropout due to untreated Demodex and MGD.

Patient & Prescribing Data

Patients with contact lens discomfort and confirmed Demodex blepharitis.

Lotilaner is administered twice daily; wait 15 minutes before lens application.

Clinical Best Practices

• Evaluate for Demodex infestation in patients with contact lens discomfort.
• Consider both lotilaner and ivermectin as treatment options.

Related Resources & Content

• Clinical factors associated with contact lens dropout
• Demodex sp. as a potential cause of the abandonment of soft contact lenses
• Lotilaner ophthalmic solution 0.25% for Demodex blepharitis