Say Goodbye to Collarettes

October 13, 2020

Many of my patients suffer from a form of eyelid inflammation, Demodex blepharitis.

Demodex is a mite that lives on human skin. Quite normal, but when Demodex get over-populated (age, poor hygiene, etc.) – that's when symptoms start. Often my patient will feel a foreign body sensation in their eye(s), stinging, and red eyelids. Sometimes even styes. Symptoms also tend to be worse in the morning than in the evening because Demodex are in a way, morning people, lol.

This is a magnified view of a Demodex mite. It feeds off epithelial cells and sebum on the eyelid margins, only to reproduce, and leave it's waste in the form of collarettes. Somebody say: gross? (photo credit: Modern Optometry)

An extremely common clinical finding is the appearance of demodex "collarettes." I always look for collarettes, as they are the strongest indicator for the diagnosis. A collarette is a little mound of light beige colored, waxy buildup on the eyelid margin. Patients sometimes report that they can see a "white line" along the eyelid margin with the aid of a 10x mirror.

This is what I see behind my slit-lamp. Waxy debris build up wrapping around eyelashes to give that classic cylindrical, collar-like appearance. Hence the term "collarette." (Photo credit: Modern Optometry)

For some reason, collarettes can really wreak havoc for some of my patients, but for others - completely asymptotic. For both cases, my goal is to remove Demodex collarettes for prevention and/or ocular relief.

Lastly, it's important that I see my patients at least once a year. My patients that blow off their annual visit and delay- delay-delay, often have a more challenging case and take much longer to find relief. So sooner is better than later. That's doctors orders.

How to scrub away collarettes

1. Place 1 drop of my Tea Tree Cleansing Oil on the Eyelid Margin Scrub Brush. Think of the brush like a little toothbrush. The tiny head allows precise cleansing and a targeted scrubbing action.

2. Carefully scrub all 4 eyelids. I have them use a 10x mirror and expect a learning curve to improve technique. watch tutorial

3. Demodex also live on the brows and nasal pores. I have my patients perform a final eyelid and face wash with my Tea Tree Eyelid & Eyelash Foaming Cleanser – making sure they target the brow and nasal area.

4. Wash the Scrub Brush with the Foaming Cleanser after each use. Let air dry.

Love + Healthy Eyes,

Dr. Tanya Gill, O.D. is the clinic director of Oakland Vision Center Optometry in Oakland, CA, USA. She graduated from the UC Berkeley School of Optometry in 1999 and is on a mission to clean every dirty eyelid in the world, including yours.