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The comparison of the diagnostic efficiency of a reference method (light microscopy [LM] using 10% potassium hydroxide [KOH]) with the use of 100% alcohol to  in vivo  confocal microscopy (IVCM) for the detection of  Demodex  eyelid infestation in seborrheic blepharitis patients. Eyelashes were epilated from the right eyes for the reference method and the left eyes for the alcohol group in 58 eyes of 29 patients. IVCM was used on the left eyes. The primary outcomes were the number of  Demodex  mites per lash and the rate of  Demodex  positivity (≥1 mite). The rate of  Demodex  positivity was similar among the three groups (KOH: 82.8%, alcohol: 86.2%, IVCM: 72.4%;  p  &gt;.05). The mean number of mites per lash in the KOH group (1.5 ± 1.3) was higher than in the alcohol (0.9 ± 0.6,  p  =.041) and IVCM groups (0.9 ± 0.9,  p  =.036). KOH was found to be superior in terms of the quantification of mites compared to alcohol and IVCM.

Investigation of the Demodex Lid Infestation with in Vivo Confocal Microscopy versus Light Microscopy in Patients with Seborrheic Blepharitis