Eyelid Health and Lid Margin Disease

By: Howell M. Findley O.D.

Given the essential role the eyelids play in protecting the eyes and vision, it is important to keep them clean and address any inflammation or irritation. Sometimes, glands in the eyelid can become blocked and dysfunctional. This specific condition goes by several names, but it is most commonly known as Lid Margin Disease. Many patients experience this chronic condition at some point in their life.

Some common symptoms of lid margin disease are:

• Crusting of eyelashes in the morning
• Red eyes in the morning
• Itching
• Uncomfortable bumps on the eyelids

Fortunately, Lid Margin Disease will respond to treatment. However, it requires several steps and an investment of time to ensure healthy results. If treatment is started and continued, the eyelids and the eyes will become healthier and more comfortable over time. If treatment is stopped, the condition and its symptoms will likely return.

The treatment program is simple but has several components, each one important in ridding the patient of the disease.

Warm Compress to Closed Eyes

Care must be used not to burn the eyelids and surrounding skin, but any warm compress will do. Reusable heating pads can be bought at any pharmacy and is recommended. Place the compress over the closed eyelids for 5 minutes. The heat opens up the oil glands on the lid margins and helps make the oils they secrete more fluid. Do this step 2-3 times per week for mild symptoms and perform daily for more severe symptoms.

Eyelid Massage

After using a warm compress, gently massage the upper and lower lids vertically with freshly washed fingers. Do this all along the upper and lower lids for about 1 minute. This massaging pushes the thickened oils out of the glands on the eyelids, helping these glands to flow more freely.

Eyelid Scrub

A doctor may prescribe a specific product, but generally baby shampoo may be used. Dilute the shampoo with warm water and use with a clean cotton pad or soft cloth. Lightly scrub the lids at the margin and rinse with clean water. Do this step once daily; and two times after makeup removal.

Eye Drops

Standard, over-the-counter artificial tears do not treat the disease, but are important to keep the eyes lubricated and to wash away potentially aggravating substances. Drops that “Get the Red Out” should not be used for daily lubrication. In addition, there are prescription drops and/or eye ointments used to treat lid margin disease and a doctor will recommend the appropriate treatment, should this be necessary.

Note: Prescription Pills

For more difficult cases, Doxycyline, an antibiotic, may be prescribed. The pills are typically taken once a day and work to make the gland secretions more liquid so that they flow better.

The goal of proper eyelid hygiene is to promote a healthier ocular surface. This benefits patients in a number of ways. In terms of surgery, a healthy ocular surface enables our doctors to more precisely measure the eye. This facilitates the best outcome for LASIK and cataract surgery as well as a better quality of vision for you! A healthy surface also promotes faster healing and a reduced risk of potential side effects. Much like brushing teeth daily promotes oral health; continued focus on effective eyelid hygiene promotes vision health.