Diagnosing and treating Phthirus pubis palpebrarum

• Published in: Survey of Ophthalmology Vol. 26; no. 4; pp. 219 - 225
• Main Authors: Couch, Jeffrey M., Green, W.Richard, Hirst, Lawrence W., De La Cruz, Zenaida C.
• Format: Book Review Journal Article
• Language: English
• Published: United States Elsevier Inc 1982
• Subjects: Adult; Blepharitis - etiology; Conjunctivitis - etiology; crab louse; Eyelashes - ultrastructure; Eyelid Diseases - diagnosis; Eyelid Diseases - drug therapy; Female; gamma benzene hexachloride; Humans; Lice Infestations - complications; Lice Infestations - diagnosis; Lice Infestations - drug therapy; Lindane - therapeutic use; Male; pediculosis; phthiriasis; Phthirus pubis; physostigmine; Physostigmine - therapeutic use; crab louse; pediculosis; physostigmine; phthiriasis; gamma benzene hexachloride; Phthirus pubis
• ISSN: 0039-6257; 1879-3304
• DOI: 10.1016/0039-6257(82)90082-0

Phthiriasis palpebrarum is an uncommon cause of blepharitis and conjunctivitis and may easily be overlooked. A high index of suspicion and careful examination of the patient's lid margins and eyelashes will lead to the proper diagnosis. Treatment is best accomplished by careful removal of the lice and nits (louse eggs) from the patient's lashes. Local application of a pediculocide such as yellow mercuric oxide N.F. 1% ophthalmic ointment applied twice daily for one week or 0.25% physostigmine (Eserine) ointment applied twice daily for a minimum of ten days, to the lid margins should be considered when the total removal of Phthirus pubis and nits is not possible mechanically. Body hair should be examined for infestation with lice and treated with gamma benzene hexachloride shampoo. This medication should be used with caution in infants, children and pregnant women. Family members, sexual contacts, and close companions should be examined and treated appropriately; clothing, linen and personel items should be disinfected with heat of 50°C for 30 minutes.