Eye disease is on the rise in the UK as lower laundry temperatures allow dust mites to thrive in our bed sheets, eye surgeons have warned.
Experts told The i Paper they have seen a sharp rise in cases of chronic eyelid inflammation, known as demodex blepharitis, as dust mites crawl into people’s eyes at night, with the average eyelash of someone with the condition containing three mites apiece.
Once in the eye lash the demodex mites unleash a mixture of faeces, partially-digested skin cells and eggs that have been dubbed “lash trash”.
These cause symptoms such as redness, swelling, inflammation on the surface of the cornea, lumps in the eyelid and can even contribute to hair loss.
And millions of people in the UK, most of them over the age of 50, are estimated to have the demodex – although there is no register of the disease, so it is not possible to give an accurate number.
Experts say the growth of demodex is a long-term trend which has accelerated in the past two to three years. And they believe the increase in low-temperature washes, as people seek to save money, is largely to blame.
Two-thirds of UK washing is now done at 40°C or less, but research has shown that a minimum temperature in the mid-50 50°Cs is needed to kill the mites, with a slightly higher temperature recommended to ensure the job is done properly.
One key study in the Parasitology Research journal subjected the mites to a range of temperatures between -15°C and over 60°C and concluded that “the lethal temperature is 54°C, and the effective temperature that kills demodex mites is 58°C”.
Eye lash collarettes or ‘lash trash’ (Centreforsight.com)Dust mites are most commonly found in bedding, mattresses, and carpets, but can also find their way into upholstered furniture, soft toys, and other dusty places. They feed on shed skin cells and prefer humid environments, meaning they can be found in sheets and pillows in large quantities.
As such, ophthalmologists strongly urge people to wash their sheets and pillows at 60°C or more hotter. But they say it’s still OK to wash clothes at cooler washes as they are unlikely contain many dust mites.
They particularly recommend that people over the age of 50 use hotter washes because the risk of demodex blepharitis becomes much greater at that age, and continues to increase over the rest of our lives.
Julian Stevens, a leading UK eye surgeon who helps Formula 1 drivers to maximise their vision, estimates that millions of people in the UK are now suffering from demodex.
“This is a massive issue,” he told The i Paper.
“Me and my colleagues are seeing more and more people at the clinic for demodex, and optometrists on the high street are also seeing a huge increase. And the reason is that, whereas our parents used to wash at 60°C and hotter, everyone’s now using low temperature washes.”
“I can see why, but people don’t realise the consequences because the mites can survive anything below 60°C,” added Mr Stevens, who was previously director of laser eye surgery at Moorfields Eye Hospital and now runs his own eye hospital.
“The only thing that we can see that’s changed is low-temperature washing. When you ask people the direct question, ‘What temperature do you wash?’ They say ‘it’s 30°C’.
“It’s built up to an epidemic in just the last two or three years,” Mr Stevens said, adding that the cost of living crisis made people want to save more money and the pandemic gave them a greater appreciation of the environment.
Sheeraz Daya, founder of the Centre for Sight eye clinic in London, Surrey and Sussex, has also seen a particularly significant rise in demodex in the past few years.
He believes cooler washes are playing a role but that an ageing population – of susceptible people – is also a key factor.
Bishwanath Pal, Consultant Ophthalmic Surgeon at Moorfields Eye Hospital, added that demodex “is often missed but can be easily treated”.
“It needs to be recognised by optometrists and general ophthalmologists so that it’s effectively diagnosed and treated,” he said.
How to get rid of dust mites
Optase gel is a weak concentration of tea tree oil that does not require prescription. It is applied to the closed eyelids, specifically rubbed into the base of the eyelashes.
This anti-mite treatment is very effective in wiping out dust mites.
The life cycle of demodex is 14 to 16 days, so commonly the treatment session is repeated after two to three weeks.
People also use tea tree oil face wash and shower gel.
For those being treated at a clinic, a stronger version of tea tree oil is available at clinics than that available over the counter.
Another treatment option is topical Ivermectin solution, which is applied to the eyelids.
A deep scrub of the eyelid margins to dislodge the demodex mites can also be helpful and is termed a Blephex treatment.
This is carried out in addition to tea tree oil or Okra treatment.
In the US, Lotilaner is available which effectively kills the mites. It is applied twice a day to the eyelid margins but is not yet available in Europe or the UK.
How to prevent dust mites
The key to long-term clearance is to avoid reinfection from mites at home.
The best way to remove dust mites from your home is by steam cleaning carpets and furniture and regularly removing dust with a damp mop or rag.
Bedding should be washed weekly in hot water to kill dust mites, especially if you struggle with allergies.
The minimum temperature is 60°C. Wash pillows and replace them after a year, as they will be covered in skin oils, germs, and drool.
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