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Purpose: The study comparatively evaluates the effectiveness of various approaches to acaricidal treatment in patients with chronic demodex blepharitis and meibomian gland dysfunctions., Material and Methods: The study included 40 patients with chronic blepharitis (CB) of demodicosis etiology in conditions of meibomian gland dysfunction (MGD) and dry eye (DE). The 1 st group of patients (20 people) received acaricidal treatment as part of therapeutic eyelid hygiene (TEH; 2 times a day) involving the use of «Blefarogel ochishchenie», «Blefarolosion», «Blefarogel forte» (contains sulfur and metronidazole). Acaricidal treatment in the patients of the 2 nd group involved applications of a product containing metronidazole (2 times a day) without TEH. Control points: 1) at inclusion in the study; 2) after a course of therapy (45 days). Evaluation included: patient acarograms, symptoms and signs of CB (points); OSDI; tear film break-up time (TBUT, sec), severity of meibomian gland dysfunction (S-MGD, points). Statistical analysis: calculation of M ± SD , Mann-Whitney, and Wilcoxon tests., Results: Acaricidal treatment was effective in both groups (reduction in demodex population, which was more pronounced in the 1 st group). Symptoms and signs of CB were significantly less pronounced in the patients of the 1 st group after therapy. The patients of the 1 st group showed a significant decrease in S-MGD, OSDI and an increase in TBUT, the 2 nd group - a significant decrease in OSDI and an increase in TBUT at the second control point. The positive OSDI and TBUT trends were significantly more pronounced in the 1 st group., Conclusion: Acaricidal treatment as part of TEH showed a significantly more pronounced reduction in demodex population, relief of CB symptoms and sign, OSDI decrease and TBUT increase, compared to the 2 nd group. Apparently, this was associated with combined acaricidal effect and significant S-MGD decrease in the patients of the 1 st group.