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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7746
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have a sore below my eye under my lower eyelid. I believe

Customer Question

I have a sore below my eye under my lower eyelid. I believe it resulted from a foreign object. The day after the object went in I noticed my lower eye lid area felt tender and later it began to swell up. Is there an oinment I can purchase at the drug store. It doesn't bother me that much until I try to sleep. At the moment it iches to distraction.
Submitted: 3 years ago.
Category: Eye
Expert:  Dr. Rick replied 3 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

are you available to chat?

Dr. Rick :

What kind of foreign body do you think went into your eyelid? What were you doing when it happened?

Dr. Rick :

hi

Customer :

Yes I can chat. I believe it was a piece of metal from a grinder but it may have been the abrasive material from the grinding disk itself. I was grinding either metal or marble.

Dr. Rick :

It is unlikely that those items entered you lid and caused a bump. It is much more likely that you have a couple of things going on: Possible allergies, mild dry eyes and -- very likely -- blepharitis causing an early chalazion to start forming.

Dr. Rick :

let me give you a little bit of information about these issues, you read it, I'll stay online and see what you think, OK?

Dr. Rick :

The most common cause for an isolated bump on the eyelid is a chalazion or a stye. These bumps form when a gland in your eyelid gets plugged up and possibly infected. It is very often associated with a condition called blepharitis.


 


The treatment for this condition, however, is not antibiotics but rather cleaning the eyelids with baby shampoo. Buy some unscented baby shampoo and, in the shower, but th shampoo on your index fingers. Close your eyes, and raise your eyelids (to get skin out of the way) and scrub back and forth along your EYELASH margin. This is where the gland openings are located. The warm water will soften the gunk in the plugged glands, the friction and pressure of your fingers will massage the glands, forcing the gunk out and the shampoo will wash it away. You can also use warm compress to the affected lids during the day as your schedule allows.



This treatment will help to treat the bump on your eyelid while at the same time solving your underlying blepharitis. The lump may take many weeks to go away but you should notice some improvement in a few days or so.


 


 

Customer :

okay

Dr. Rick :

here's the data on allergies and blepharitis:

Dr. Rick :

It sounds like you have a couple of things going on. First is allergies, second dry eyes and third blepharitis.


 


When it comes to allergies it is almost impossible to pin down the offending agent(s) and, therefore, treatment needs to focus on controlling the symptoms. Dry eyes is very common and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, then temporary punctal occlusion of the lower puncta, then temporary occlusion of all 4 puncta then surgical ( non-reversible) closure of the puncta.


 


Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk.


 


The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on you eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.


 


Baby shampoo lid scrubs will also help to wash away allergens and stimulate tear production, thereby addressing all three of your issues. Remember, this is not an instant fix. While you are waiting for the lid scrubs to have affect you can use over the counter allergy pills such as Travist, dimetapp or Zyrtec.


 


Should your symptoms get worse, your vision become significantly affected or things just not get better in 3 weeks or so you should have a complete eye examination by your local ophthalmologist to look for other, less common, causes of your symptoms.


 


 

Dr. Rick :

You can also get some 1% hydrocortizone cream and apply it to the area to help with the itching until the lid scrubs "kick in"

Dr. Rick :

does that make sense to you?

Customer :

Yes it does. thank you I will proceed as you recommend. Is it relevant that: 1) it is the lower eye lid 2) it is quite red

Dr. Rick :

The conditions discussed above, especially an early chalazion/stye are common on the lower lid and do make it turn red. Having a foreign body get embedded deep in your lid from grinding marble or the grinding wheel (except for wires off a wire wheel....) is very, very unlikely. In your case we have to apply what I like to call the "duck theory of ophthalmology": If it walks like a duck, quacks like a duck and flies like a duck -- hurry up and shoot it as it IS a duck. If you get what I mean :o)

Customer :

All right, great. thank you.

Dr. Rick :

my pleasu

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7746
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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