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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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My right eyelid is stuck together in the morning when I awake.

Resolved Question:

My right eyelid is stuck together in the morning when I awake. I pry them apart and can see OK. I have a wet tear-like eye sometimes. Is there a prescription I can order or over-the-counter product that you recomend?
Submitted: 5 years ago via HealthBoards.
Category: Eye
Expert:  Dr. Dan B. replied 5 years ago.
Hello and thanks for your question. If this is a common, chronic occurrence, there are two things that usually cause this: eyelid inflammation (blepharitis) and allergies. Blepharitis causes the tear film that is supposed to coat the front of the eye to not function as well, and then the eyes dry out. People with blepharitis have morning tearing, burning, and often eyelash mattering. Their symptoms get better as the day progresses, but then they get intermittent blurring when they use their eyes heavily in activities such as reading, watching TV, computer use or driving.


The best baseline treatment for this is artificial tears. However, they usually don't work unless they are used regularly, 3-4x/day for 2-3 weeks. If they are just used only when your eye is irritated, then they don't provide any treatment for the dry eyes beyond the 30 seconds of relief after putting them in.


If after two weeks of doing this, if things are no better you might consider starting other treatment for blepharitis, while concurrently continuing artificial tears, as it is relatively benign and often produces a good result. In order to treat blepharitis, everyday in the morning you should do two things: 1. hot compresses and 2. eyelid scrubs. You should do hot compresses for 5-10 minutes over each eye at the same time. It should be as hot as you can tolerate without burning your skin, massaging the eyelids while they are on there. Then, use either commercially available preparations or a dilute baby shampoo solution to scrub your eyelashes on all 4 eyelids. The commercially available preparations are called Ocusoft or Sterilid which are both over-the-counter eyelash scrubbing treatments. These cost more money but are quicker to use. Otherwise, the cheaper alternative is the dilute baby shampoo (4-5 drops Johnson's shampoo in 1/4 cup warm water), you will take the wipe (or dip a qtip in the dilute baby shampoo solution) and use that to scrub right on the eyelashes of each eyelid for 15 seconds. That will take 60 seconds when done to all 4 eyelids. The scrubbing is done right on the eyelid margin, where the eyelashes come out. After that, just splash some water on the eyes and you're done.


It does take about 3-4 weeks of doing this consistently every day before it really kicks in, so don't stop it thinking it's not working. Also the eyes are still significantly dry during this 3-4 weeks so use the artificial tears you bought 4x/day in both eyes (one drop per application). After 4 weeks you should be able to start tapering off of the tears to as you need them.


Just doing the artificial tears, hot compresses and eyelid scrubs alone would likely start to help you after three or 4 weeks--but remember it could take this long of doing it everyday before you see a significant effect, so don't stop it thinking it's not working.


If there is significant itching associated with this, then it is likely allergic in nature and will respond to cool compresses several times throughout the day, an allergy drop such as Zaditor or Alaway (can be purchased over-the-counter) or a prescription drop such as Pataday, and possibly an oral antihistamine such as claritin or zyrtec.


If this is only an episode and does not happen on a regular basis, then this may represent an infection. If there is relatively little discharge and is only on the lashes in the morning, and not yellowish/greenish and thick, it is likely viral in nature and there are no drops that will eradicate that, it just has to run its course. If there is copious amounts of yellowish/greenish discharge and the eye is significantly red, then it is likely a bacterial infection and you would need to see your eye doctor to get a prescription antibiotic drop as there is nothing over-the-counter that you can use to treat that.


Does this information help address your concerns? Does this make sense? Do you have any other concerns that I haven't addressed?


I am happy to be able to help you today. I will also be happy to answer any other questions until you have the information you need.


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My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.

Customer: replied 5 years ago.


I forgot to tell you that I had a lens implant in my right eye @ Jules Stein Eye Clinic (@UCLA) last June and I have been advised not to rub my eye. Also I do have a small amount of matter at the bottom ends of my eye, not on the lashes.

Expert:  Dr. Dan B. replied 5 years ago.
That's good advice. The compresses can be held against the eye without putting significant pressure on the eye or pressing on the eye. Does this treatment for the inflammation make sense? Do you have any other questions I have not addressed?
Customer: replied 5 years ago.



Is this also known as "dry eye"? Is there a brand name for the tears product?

Expert:  Dr. Dan B. replied 5 years ago.
Yes, this inflammation most definitely leads to dry eye syndrome. There are a handful of different brand names that some like more than others. A few that my patients like include Systane, Blink, and Soothe. As long as it doesn't say get-the-red-out or redness-reliever then just about any kind of artificial tear is acceptable to use. Does that make sense?
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