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Xdemvy beats OTC options for contact lens wearers with Demodex blepharitis. A real-world study found that contact lens patients using Xdemvy (lotilaner 0.25%) reported significantly greater reductions in itchy eyelids, eye dryness, and eyelid redness compared to those using tea tree cleansers, warm compresses, or artificial tears. With 30% of contact lens patients going untreated, one optometrist says the findings are changing how he prescribes.
Xdemvy pulls ahead of OTC options for contact lens wearers battling Demodex blepharitis
A real-world interim study presented at Academy 2026 found that contact lens patients using Xdemvy (lotilaner ophthalmic solution 0.25%) experienced significantly greater symptom relief than those relying on over-the-counter or in-office alternatives. The ongoing survey-based study tracked 87 patients with soft contact lens intolerance and Demodex blepharitis over six months, comparing lotilaner users against those using common alternatives like tea tree eyelid cleansers, warm compresses, and lubricating eye drops.
At one month, lotilaner users reported significantly reduced frequency and severity of itchy eyelids, eye dryness, and gritty/sandy eyes. By three months, those benefits held — and extended to eyelid redness and morning crusting. Lead researcher Dr. Keith Wan called the difference between treatments "pretty amazing," noting it's reshaping his prescribing habits.
By the Numbers
Why it matters: Contact lens wearers with Demodex blepharitis are an often-overlooked patient group at risk for dry eyes, redness, and lens dropout. These findings suggest that prescribing Xdemvy over OTC alternatives could meaningfully improve comfort and retention in this population.
