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Short-term tolerability of commercial eyelid cleansers: A randomised crossover study

      Highlights

      • Randomised crossover study (n = 30) comparing short-term tolerability of five commercial anti-demodectic lid cleansers.
      • Subjective discomfort, tear film and ocular surface parameters assessed over 10 min following product application.
      • All products induced significant ocular discomfort lasting for 60 to 195 s following product application.
      • Deterioration in tear film stability, conjunctival hyperaemia, ocular surface staining noted following Chrissanthe Eye Cleanse application.
      • Increased bulbar conjunctival hyperaemia observed following I-MED I-Lid’n Lash Plus application.

      Abstract

      Purpose

      To evaluate the short-term tolerability of five commercially available anti-demodectic eyelid cleansers; OCuSOFT Oust Demodex (OD), I-MED I-Lid’n Lash Plus (ILL+), Labtician BlephaDex (BD), Chrissanthe Eye Cleanse (EC), and Théa Blephademodex (BDdx).

      Methods

      Thirty healthy non-contact lens wearers (18 female; mean ± SD age, 33 ± 12 years) were enrolled in a prospective randomised crossover study. On separate visits, spaced at least 48 h apart, participants were randomised to receive topical application of one of five eyelid cleansers or saline. Participants rated subjective ocular discomfort during the 10-minute post-application period. Visual acuity, non-invasive tear film stability, conjunctival hyperaemia, and ocular surface staining were assessed at baseline and 10 min.

      Results

      No inter-group differences in ocular parameters were noted at baseline (all p > 0.05). Ocular discomfort scores significantly exceeded baseline scores for 60 s following BD application, 120 s with OD, 135 s with BDdx, 150 s with ILL+, and 195 s with EC (all p < 0.05). Deterioration in non-invasive tear film stability, limbal conjunctival hyperaemia, as well as corneal, conjunctival, and lid margin staining was detected following EC application (all p < 0.05), and increased bulbar conjunctival hyperaemia was observed following both EC and ILL+ treatment (both p < 0.05).

      Conclusions

      Study outcomes highlight varying tolerability profiles with different anti-demodectic lid cleanser preparations, and the potential to induce tear film instability, conjunctival hyperaemia and ocular surface staining on application. Awareness of possible adverse effects arising from topical application of commercial anti-demodectic lid cleanser formulations may help clinicians set realistic patient expectations and encourage better compliance in their use of lid hygiene therapies.

      Keywords

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