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Dr. James
Dr. James, Board Certified Ophthalmologist
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Swelling above both eyelids and sometimes below my eyes. has

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Swelling above both eyelids and sometimes below my eyes. has not responded to corticosteroids. I have rosacea, fibromyalgia, and arthritis, and diabetes (Type II) The swelling has come and gone within a few days time over the past few years. This time it is not going away. Also, in the morning, there is a clear but thick discharge that is somewhat of a problem to wipe away. Any ideas?
Submitted: 5 years ago.
Category: Eye
Expert:  Dr.S Riaz replied 5 years ago.

Hello Customer,

 

It looks like you have meibomitis which is nothing but inflammation of meibomitian glands present on the lid margins. The openings of the meimion glands on the margins are blocked. An inspissated toothpaste like material can be seen at the lid margin difficult to wipe away. This condition can cause dryness in the eyes leading to redness and burning in severe cases. Warm compresses should be done. A course of oral doxycycline can be helpful. A lubricating eye drop should also be used. You can see an ophthalmologist to confirm it. Thanks.

 

 

Customer: replied 5 years ago.
I have no problem with dryness. There is no redness, just swollen above the eyelid and below the eyebrow. Any other ideas? The discharge is like tears but thicker and is only present first thing in the morning. If I don't wipe it away, it eventually goes away by itself.
Expert:  Dr.S Riaz replied 5 years ago.

Dryness may not be there in initial stages of meibomitis. However, the other likely possibility is rosacea. You can use an eye ointment like Tetracyclline at bedtime. It is helpful in both rosacea and meibomitis. Also use the Visisne eye drop that you have been using. If ithis does not help, see a dermatologist/ophthalmologist. Thanks.

 

 

Customer: replied 5 years ago.
None of the above symptoms of meibomitis applies to me except the watery eyes in the morning. My eyes are not affected at all otherwise
Customer: replied 5 years ago.
I asked for another physician to reply but no one has as yet. Where are we in this process?
Expert:  Dr. James replied 5 years ago.
Hello,

I am another expert here on JustAnswer. If you would like me to help, please answer the following questions?

Is the swelling in the upper and lower eyelids?
When did this current episode start?
When was the last time you were seen by an ophthalmologist?
What eyedrops are you using?
Customer: replied 5 years ago.
The swelling is in my upper lids, but occasionally there is a deep crease running from the tissue under my eyes straight down into my cheek.

The current episode has been going on for two to three months. My family physician is currently trying me on a second round of the prednisone in addition to the eyedrops.

I saw an opthamologist on the 30th of June of this year. He thought the thick morning discharge was a result of my eyes not staying completely closed a night because I had become so relaxed.

The eyedrops I used were a prescription but the bottle is a home, so I can't tell you the name. I was to put in drops once a day and keep my eyes closed for 15 minutes. The drops stung a tiny bit, but after a week, the swelling was actually worse, so I discontinued them.
Expert:  Dr. James replied 5 years ago.
Thank you for the response.

I agree with Dr. Riaz that dry eyes and blepharitis would be the first thought. It appears your ophthalmologist in June had a similar diagnosis with likely steroid eye drops and lubrication. As you mentioned, you do not have the typical symptoms of dry eyes besides the eyelid swelling, but this can still be a possibility. The mucous discharge in the morning is very suggestive of overnight drying. I recommend you use a lubricating ointment in your eyes before bedtime.

Eyelid swelling can also be an early sign of thryoid eye disease. This is commonly associated with hyperthyroidism (Graves disease). If you haven't been checked for that in the last 1-2 years, I would recommend you ask your family physician to check a TSH, T4, and TSI.

Another possibility to consider would be blepharochalasis syndrome. This syndrome has an unknown cause but is characterized by repeat bouts of upper eyelid swelling and resulting thinning and stretching of the upper eyelid skin. As the link above describes, it starts in the teen years, so this would be less likely for you.

Remember to press the green ACCEPT button. It was a pleasure helping you with your question. Best wishes to you. Feel free to ask any additional questions.
Customer: replied 5 years ago.
Last question, could this be Morbihan's Disease?
Expert:  Dr. James replied 5 years ago.
Yes, a possibility since Morbihan's Disease is characterized by chronic persistent erythema and edema of the upper half of the face. A dermatologist would be better able to assess this. Blepharitis, rosacea, thyroid be more likely, however.

Please remember to accept if my answers have been helpful.
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience: Eye Physician and Surgeon
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