This is a very common condition affecting the eyelid margins of both eyes. Both men and women get it and it can be very annoying. It is caused by a low grade infection from common skin bacteria at the eyelashes and causes crusting, irritation, lid margin redness, reflex tearing, and burning and itching. There can be acute exacerbations with a lot of redness at the lid margins and on the eye associated with irritation and discharge or be a chronic blepharitis with mild "red rimmed" eyes with scaly crusting and mild irritation. It is sometimes called "dandruff" of the eyelids.
1. Lid Hygiene
This is the mainstay of treatment. Lid hygiene helps remove the crusts and toxic (harmful) products from the lid margin which make the eyelids red and eyes sore. It also helps massage the oily producing meibomian glands in the eyelids to help them unplug and the oil reach the tear film surface and improve the tear quality.
2. Antibiotic Ointment.
If indicated, antibiotic ointment may be prescribed for a couple of weeks to treat the low grade infection.
3. Antibiotic tablets.
Sometimes a long course (6 months or longer) of antibiotic tablets which are commonly used for acne are prescribed to improve overall skin quality and the meibomian gland oil quality. Your surgeon will advise you.
How to do Lid Hygiene:
Dilute baby shampoo
- Wash your hands
- Make up a solution of dilute baby shampoo and sodium bicarbonate solution
- Two drops of baby shampoo in one cup of boiled but cooled water
- Sodium bicarbonate solution
- 1 teaspoon of sodium bicarbonate (cooking soda) in one cup of water which has been boiled and cooled.
These may be stored in the fridge for 24 hours
- Use a cotton wool pad and cotton tip (Q-tip) and dip these in the solution (it must be cool enough to put near the eyelids)
- Place a cotton wool pad on the eyelids and let them soak for about a minute to soften the crusts.
- Gently but firmly wipe along the eyelash margin to remove the crusts and debris with the pad then with the cotton bud at the lashes. First go horizontally then in an up and down direction, keeping at the roots of the eyelashes.
- Do this twice daily when there is an exacerbation, otherwise once daily
- If you have been prescribed antibiotic cream, put this along the lid and eyelash margin after lid bathing.
- Lid hygine may make the eyelids look a bit red for 15 minutes as it increases the circulation to the eyelids