Purpose of Review <p>This review aims to examine the role of <i>Demodex</i> mites (<i>D. folliculorum</i> and <i>D. brevis</i>) in the pathogenesis of blepharitis, and to evaluate the current clinical approaches to diagnosis and management. The central question addressed is how do <i>Demodex</i> infestations contribute to ocular surface inflammation, and what are the most effective, evidence-based treatments available.</p> Recent Findings <p>Blepharitis is a chronic inflammatory eyelid condition that may be anterior or posterior in presentation. Growing clinical evidence links <i>Demodex</i> infestation with eyelid inflammation, tear dysfunction, and bacterial overgrowth especially <i>Staphylococcus</i> and <i>Streptococcus</i> species. Transmission is primarily through direct contact and shared cosmetics. Multiple therapeutic agents have shown efficacy Tea tree oil products, particularly tree oil shampoo, exhibit superior efficacy in reducing mite load with minimal side effects. Coconut oil alleviates symptoms but does not eradicate mites. Topical ivermectin and Lotilaner have also shown promising results in symptom improvement and mite elimination, with fewer systemic effects than oral agents.</p> Summary <p><i>Demodex</i>-associated blepharitis is an underdiagnosed contributor to ocular surface disease. High mite burden may lead to primary or secondary demodicosis. Current treatments including tree oil, ivermectin, and Lotilaner offer effective, relatively safe options. Future research should focus on improving diagnostic tools, defining optimal treatment regimens, and further elucidating the link between <i>Demodex</i> and ocular co-morbidities such as dry eye and meibomian gland dysfunction.</p>