Eyelid lumps caused by Blepharitis (4)

In the last few posts on this blog, we've been discussing Blepharitis, the most common cause of irritating eyes. Now to complete the subject of blepharitis, we'll just cover the best ways to treat the two most common types of eyelid lumps, both of which are caused by Blepharitis. Most people will suffer one or more of these at some time or other, and knowing how to treat them, and how important it is to commence treatment the day they appear, is key to resolving them promptly and successfully.

Chalazion (= Meibomian Cyst) (= Internal Hordeolum)

These are accumulations of oil within the larger oil-producing glands of the eyelids:

 You can distinguish these from styes (see below) by their position further away from the lid margin - higher in the upper lids and lower in the lower lids.

To treat these cysts, warm compresses (part of the treatment for Blepharitis) are the most important thing - what you're trying to do is to melt the oils that are blocking the meibomian gland ducts and preventing the produced oil from leaving the gland. You need 10 - 30 minutes of very warm compresses on the chalazion, several times per day if you are to have any chance of getting rid of it without an operation; this is actually quite difficult to achieve with hot wet flannels - the flannels cool too quickly, and water gets everywhere especially if you try to lie down for the 10 minutes which is the most comfortable way to do this treatment. A more convenient way to do this heat treatment is to purchase one of the commercially available heat pads that you microwave for approx. 30 seconds and then apply to the eyes using an elastic strap round the head - you can then sit or lie back and allow the heat to do its work.
After each heat treatment, massage gently downward from above the chalazion toward the lid margin; this will encourage movement of the liquefied oil out of the gland.

If all the above fails to make any headway in shrinking and resolving the chalazion, then an eye specialist can do a small operation to remove it - it's not very traumatic surgery, but it's still worth giving the above non-surgical treatments a good try first ! But if you do need to have one removed, St. Albans Medical Centre has a painless, 2-minute method of removing any lumps on or around the eyelids - click HERE for their website.

Stye (= External Hordeolum)

These are small infections within the tiny oil-producing glands on the lid margin.

In much the same way as chalazia (see above), they're caused by blockage of the gland ducts by solidifying oils, thereby blocking the exit of oil from the gland and causing the oil to accumulate within the gland. So once again treatment involves warm pads to melt the oils, followed by massage from above the lump, toward the lid margin. However, because the glands involved in Styes open out into the hair follicles rather than onto the skin surface, it is possible to facilitate emptying of the gland by pulling out the appropriate eye lash. However, you should then continue to treat the blepharitis with warmth, massage and cleaning (see post below on how to control your blepharitis).

For both Chalazia and Styes

One of the most important factors to bear in mind is to start treating a chalazia/stye as soon as it begins to appear i.e. within a day or two; at this very early stage the lump just contains liquid oil/pus, and can drain quite easily with hot compresses and massage. If they are left for weeks or months, then a solid granulomatous component appears within the gland, making them much more difficult, or impossible, to empty completely.













Pictures courteusy of Medicinenet.com, with thanks. You can visit their excellent site by clicking here

If you have long-term itchy, uncomfortable eyes/eyelids, the most likely cause is Blepharitis. (1)

The most common reason for people to have long-term itchy or slightly uncomfortable eyes is inflammation in the skin around the bases of the eyelashes i.e. at the lid margins, and is called Blepharitis.

Blepharitis is not usually due to tissue infection, but rather is due to inflammation only. However, organisms (usually bacteria or yeasts) on the skin surface do play a part in causing the inflammation.

It can develop at any age, and symptoms can include:

• itchy, sore and red eyelids that stick together
  
• crusty or greasy eyelashes
• a burning, gritty sensation in your eyes
• increased sensitivity to light (photophobia)
• swollen eyelid margins
• finding contact lenses uncomfortable to wear
• abnormal eyelash growth or loss of eyelashes in severe cases

In most cases both eyes are affected, but one eye can be more affected than the other. The symptoms tend to be worse in the morning.

Blepharitis is usually a long-term condition. Most people experience repeated episodes, separated by periods with reduced symptoms.

Blepharitis isn't contagious.

What causes blepharitis?

Blepharitis is usually an interaction between oils produced by the eyelid glands and the bacteria/yeasts that live on the glands. Occasionally an aggressive bacterium (Staphylococcus Aureus) is a significant part of the cause, and in these cases a few days of treatment with antibiotic (ointment rubbed into the lashes twice per day) is very helpful.

Blepharitis can be divided into three types: Anterior, posterior, and mixed (anterior and posterior). The subdivision into these three types is not clinically very useful because 

i) the mixed type is by far the most common, and

ii) the treatments outlined above are used effectively for all three types.

Sometimes blockages in the Meibomian glands are associated with a skin condition called rosacea. If too much oily substance is being produced, this may be caused by seborrhoeic dermatitis which commonly affects other areas of the body (e.g. the face and/or scalp) and many people with itchy eyelids due to blepharitis also have itchy, flaky ("dandruff") scalp.

When to get medical advice

See your high-street optician (optometrist) or an eye specialist if you have persistent symptoms of blepharitis that aren't being controlled by simple eyelid hygiene measures.

If you have severe symptoms (for example severe redness or lid swelling), contact your optometrist or GP immediately. If this isn't possible, visit your nearest accident and emergency (A&E) department.

How blepharitis is treated

A tendency to blepharitis can't be cured, but the condition can be completely controlled - it's exactly the same idea as washing your hair regularly to prevent itching and inflammation of your scalp, and a daily eyelid-cleaning routine can help control the symptoms and prevent permanent scarring of the eyelid margins.

There are three main steps to eyelid hygiene that should be performed, morning and evening to start with, and then most people find that about three times per week is enough to keep control of it: 

• using a warm compress – to make the oil produced by the glands around your eyes more liquid so it can flow out of the glands instead of blocking them. Heat pads that can be warmed in the microwave and rested on your closed eyelids have been proven to be very effective in reducing/removing symptoms and preventing long-term complications of blepharitis.
• gently massaging your eyelids – to push the oils out of the glands
• cleaning your eyelids – to wipe away any excess oil and remove any crusts, bacteria, dust or grime that might have built up

More severe cases may require antibiotics that are either applied to the eye or eyelid directly, or taken as tablets.

Complications

Blepharitis isn't usually serious, although it can lead to a number of further problems.

In the next post (above) we'll begin to look at the more serious problems that can occur if blepharitis remains untreated for years, and therefore why the relatively simple treatments outlined above should be commenced whilst the condition is mild - if you have irritating eyes, don't put up with it - get it sorted.

How is the name "Blepharitis" derived ?

Inflammation is the response of the body to noxious stimulus (chemical/injury/infection).

The Greek word for eyelid is "blephar" and the suffix "-itis" (again from Greek) is appended (as it is to the name of any body structure) to indicate inflammation. 

Authoritative government source: 

http://www.nhs.uk/conditions/Blepharitis/Pages/Introduction.aspx