instruction: hello doctor I have been suffering from dry eyes for four years I have seen many eye doctors but no cause has been found a while ago I started noticing my eye lids looking weird I also discovered I had demodex mites on my face but none were found on my eyelashes however I made some photos of my eye lids and found the base of my eye lashes looked white my question is could this after all be the sign of demodex mites during these four years of dry eyes I get occasional left eye pains the problem is exacerbated by computer use reading being outdoors my eyes are not red no blurred vision no excess tearing warm compresses eyelid massages eyelid hygiene and diet changes did not help around a year ago eye lid problems started my eyelashes do not fall out easily though
output: hi we do have natural microbe or flora on our face and eyelashes but demodex mite cannot be it is a foreign microbe that needs to be treated I can see the images and there is redness beneath the eye and also white at the base of the eyelash there are many reasons for it firstly are you having psoriasis which itself can be flared up and needs treatment by a skin specialist this also has an effect on eyes causing dryness and burning secondly as you are saying dandruff that you have to check do you observe it at your hairs shoulders and eyebrows that also has to be treated by antidandruff shampoo again call for a skin specialist thirdly blepharitis because it also causes similar symptoms apart from the face do you have any other symptoms like thirsty mouth itching in any part of the body or rashes well I would suggest you to get it checked once with a skin specialist also because it is now a chronic condition I will write medications for you eye ointment dexamethasone over the eyelashes at night and day for 15 days eye drop systane ultra polyethylene glycol four to five times a day for 15 days eye ointment neosporin at the face just down to eyes where rash is there genteel gel at night and day inside the eye use any anti dandruff shampoo use anti mite shampoo for hairs lid scrub by scrubbing it with buds dipped in one part of shampoo and two parts of water this should be continued for 15 days please consult a skin specialist it is important since you are so much in pain