AIM: To study the infection of Demodex folliculorum and the efficacy of tea tree essenial oil combined with fluorometholone for elderly patients with meibomian gland dysfunction(MGD).

METHODS: In this retrospective clinical control study, a total of 59 elderly patients(118 eyes)with MGD were included in Ningbo Eye Hospital during September 2017 to March 2018. Symptoms score, Demodex number, Tarsal gland morphology, tear break-up time(BUT), Fluorescein staining(FL)and Schirmer test(SIaT)were evaluated in 38 patients(76 eyes)with positive eyelash examination. The patients were divided into three groups and treated with different methods after blepharoplasty-Groups A(24 eyes), B(26 eyes)and C(26 eyes)were treated with 0.02% fluorometholone eye drops; tea tree essential oil wipes; and 0.02% fluorometholone eye drops combined with tea tree essential oil wipes, respectively. The follow-up was 4wk.

RESULTS: The eyelash Demodex was detected in 76 eyes(64.4%). The scores of subjective symptoms in the three groups were improved after treatment(P<0.05). There was no statistical difference in the number of Demodex before and after treatment in group A(P=0.11); there were statistical differences in groups B and C(P<0.01). There was no significant difference between group A(P=0.22), groups B and C had significant difference(P<0.05)in BUT before and after treatment. BUT in group C was longer than that in groups A and B, and the difference was statistically significant(P<0.05)after treatment. FL scores of the three groups before and after treatment were significantly different(P<0.05).

CONCLUSION: The infection rate of Demodex mites in eyelashes of elderly patients with MGD is higher. Tea tree essential oil wipes combined with 0.02% fluorometholone eye drops can effectively repel mites, improvement of lipid secretion by meibomian gland, and relieve local symptoms of MGD.