Ocular Comfort and Inflammation in Lid Hygiene Therapy

Inclusion Criteria: * Subject signed and dated a IRB-approved informed consent document * Mild or greater Demodex (minimum 15 observable mites in six lashes) * Score of 20 or more on the OSDI Questionnaire * Score of 20 or more on the Eyelid Inflammation Questionnaire Exclusion Criteria: * Currently enrolled in another prospective research study * Unable to attend two follow-up visits over 30 days * Current allergic conjunctivitis of the cornea, conjunctiva, or eyelid in either eye * Prior ocular trauma where surgery was indicated * Prior corneal transplant in either eye * Any ocular surgery within the past six months * Abnormal corneal scarring, erosions, or Stevens-Johnson syndrome * Anticipation of ocular surgery within the next 30 days * Non-English speaking * Pregnant, nursing, or expect to become pregnant within the next 30 days * Known sensitivity to chlorine or Avenova * Moderate, or severe conjunctivochalasis * Contact lenses within the last 30 days and unwilling to discontinue for 30 days * Use of topical cyclosporine for less than 6 continuous months prior to baseline * Procedure such as pulsed light or commercial lid massage in last 30 days * Known history of autoimmune disease * Punctal plugs placed within the last 30 days * Use of Avenova or other lid cleansers within the last 30 days * Changes in systemic or ocular medications in the last 30 days * Unwilling to commit to the same ocular and systemic medications for 30 days